Healthcare Provider Details

I. General information

NPI: 1114925799
Provider Name (Legal Business Name): QUALITY HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 12/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 FRANKLIN ST SUITE 203
MORRIS IL
60450-1880
US

IV. Provider business mailing address

519 FRANKLIN ST SUITE 203
MORRIS IL
60450-1880
US

V. Phone/Fax

Practice location:
  • Phone: 815-942-1256
  • Fax: 815-942-5203
Mailing address:
  • Phone: 815-942-1256
  • Fax: 815-942-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1001478
License Number StateIL

VIII. Authorized Official

Name: MR. FRITZ LUZ
Title or Position: PRESIDENT
Credential:
Phone: 815-942-1256