Healthcare Provider Details

I. General information

NPI: 1730641465
Provider Name (Legal Business Name): QUALCARE NURSE REGISTRY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7491 WEST OAKLAND PK BLVD 304
LAUDERHILL FL
33319-4382
US

IV. Provider business mailing address

7491 WEST OAKLAND PARK BLVD STE - 304
LAUDERHILL FL
33319-4970
US

V. Phone/Fax

Practice location:
  • Phone: 954-638-4572
  • Fax: 954-634-5699
Mailing address:
  • Phone: 954-638-4572
  • Fax: 954-634-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. LEONARD W BAILEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 954-638-4572