Healthcare Provider Details

I. General information

NPI: 1225649460
Provider Name (Legal Business Name): QUALITY CARE HOME HEALTHCARE COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 HAMPTON POINT DR STE 3
ST AUGUSTINE FL
32092-3060
US

IV. Provider business mailing address

4009 LONICERA LOOP
ST JOHNS FL
32259-4532
US

V. Phone/Fax

Practice location:
  • Phone: 904-679-3632
  • Fax: 904-460-2802
Mailing address:
  • Phone: 904-679-3632
  • Fax: 904-460-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. NKWENTI NDE
Title or Position: PRESIDENT
Credential:
Phone: 352-219-7115