Healthcare Provider Details

I. General information

NPI: 1932851870
Provider Name (Legal Business Name): QUALITY CARE PROVIDERS HOMEMAKER & COMPANION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 NELLE AVE APT D
PANAMA CITY FL
32404-7748
US

IV. Provider business mailing address

283 NELLE AVE APT D
PANAMA CITY FL
32404-7748
US

V. Phone/Fax

Practice location:
  • Phone: 448-220-9124
  • Fax:
Mailing address:
  • Phone: 448-220-9124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MISS KIM LASHUN SMITH
Title or Position: OWNER
Credential: ADMINISTRATOR
Phone: 448-220-9124