Healthcare Provider Details

I. General information

NPI: 1902191471
Provider Name (Legal Business Name): QUALITY CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E MAIN ST
EAST PRAIRIE MO
63845-1123
US

IV. Provider business mailing address

211 E MAIN ST PO BOX 126
EAST PRAIRIE MO
63845-1123
US

V. Phone/Fax

Practice location:
  • Phone: 573-649-9082
  • Fax: 573-649-9626
Mailing address:
  • Phone: 573-649-9082
  • Fax: 573-649-9626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHY ANN JACKSON
Title or Position: RN - OWNER
Credential: RN
Phone: 573-649-9082