Healthcare Provider Details

I. General information

NPI: 1518457530
Provider Name (Legal Business Name): ASSURED QUALITY HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 NORTHERN BLVD.
GREAK NECK NY
11021
US

IV. Provider business mailing address

885 NORTHERN BLVD.
GREAK NECK NY
11021
US

V. Phone/Fax

Practice location:
  • Phone: 718-423-2559
  • Fax:
Mailing address:
  • Phone:
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. NATALIE C. BERLIN
Title or Position: TREASURER
Credential:
Phone: 718-423-2559