Healthcare Provider Details

I. General information

NPI: 1255906020
Provider Name (Legal Business Name): EXQUISITE QUEENS IN-HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14211 EVENTIDE DR
CYPRESS TX
77429-3907
US

IV. Provider business mailing address

14211 EVENTIDE DR
CYPRESS TX
77429-3907
US

V. Phone/Fax

Practice location:
  • Phone: 281-653-2468
  • Fax: 832-213-2412
Mailing address:
  • Phone: 281-653-2468
  • Fax: 832-213-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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
# 3
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: BETH ANDERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 281-653-2468