Healthcare Provider Details

I. General information

NPI: 1477867638
Provider Name (Legal Business Name): EXQUISITE QUEENS IN- HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 08/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14211 EVENTIDE DR
CYPRESS TX
77429
US

IV. Provider business mailing address

14211 EVENTIDE DR
CYPRESS TX
77429
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BETH ELLEN ANDERSON
Title or Position: DIRECTOR
Credential:
Phone: 281-653-2468