Healthcare Provider Details

I. General information

NPI: 1124681390
Provider Name (Legal Business Name): INNER QUALITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 HIGHWAY 171
STONEWALL LA
71078-9403
US

IV. Provider business mailing address

PO BOX 538
STONEWALL LA
71078-0538
US

V. Phone/Fax

Practice location:
  • Phone: 318-906-5054
  • Fax:
Mailing address:
  • Phone: 318-905-5054
  • 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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: TANESHA WILLIAMS HALL
Title or Position: OWNER.ADMINISTRATOR
Credential:
Phone: 318-474-8111