Healthcare Provider Details

I. General information

NPI: 1184703589
Provider Name (Legal Business Name): QUALITY HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3607 BEATTIES FORD RD
CHARLOTTE NC
28216-3249
US

IV. Provider business mailing address

3607 BEATTIES FORD RD
CHARLOTTE NC
28216-3249
US

V. Phone/Fax

Practice location:
  • Phone: 704-394-8968
  • Fax: 704-394-8967
Mailing address:
  • Phone: 704-394-8968
  • Fax: 704-394-8967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number870442
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. RASHAWN D FLOURNOY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 980-285-3388