Healthcare Provider Details

I. General information

NPI: 1871866053
Provider Name (Legal Business Name): A & S QUALITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 10/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6965 PIAZZA GRANDE AVE # 210-5
ORLANDO FL
32835-8779
US

IV. Provider business mailing address

9314 LAKE FISCHER BLV
GOTHA FL
34734
US

V. Phone/Fax

Practice location:
  • Phone: 407-592-3832
  • Fax: 407-294-3872
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: SHIRLEY SIMMONS
Title or Position: PRESIDENT
Credential:
Phone: 407-592-3832