Healthcare Provider Details

I. General information

NPI: 1871141887
Provider Name (Legal Business Name): QUALITY CARE METRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4454 N DECATUR BLVD
LAS VEGAS NV
89130-5286
US

IV. Provider business mailing address

4454 N DECATUR BLVD
LAS VEGAS NV
89130-5286
US

V. Phone/Fax

Practice location:
  • Phone: 702-507-0985
  • Fax:
Mailing address:
  • Phone: 702-507-0985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246YR1600X
TaxonomyRegistered Record Administrator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: ED ELLSWORTH
Title or Position: COO
Credential:
Phone: 702-507-0985