Healthcare Provider Details

I. General information

NPI: 1053643957
Provider Name (Legal Business Name): QUALITY HOME HEALTH I LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4242 HIGHWAY 1192
MARKSVILLE LA
71351-4710
US

IV. Provider business mailing address

PO BOX 373
BELZONI MS
39038-0373
US

V. Phone/Fax

Practice location:
  • Phone: 318-253-5143
  • Fax: 662-247-4924
Mailing address:
  • Phone: 662-247-1254
  • Fax: 662-247-4924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2203781716
License Number StateLA

VIII. Authorized Official

Name: CLARA T REED
Title or Position: CEO
Credential: RN
Phone: 662-247-1254