Healthcare Provider Details

I. General information

NPI: 1922856665
Provider Name (Legal Business Name): QUALITY KARE HEALTH KARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36372 LECATO RD
BELLE HAVEN VA
23306
US

IV. Provider business mailing address

PO BOX 42
BELLE HAVEN VA
23306-0042
US

V. Phone/Fax

Practice location:
  • Phone: 757-792-7164
  • Fax: 757-779-0001
Mailing address:
  • Phone: 757-792-7164
  • Fax: 757-779-0001

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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: QUIANA REYNOLDS
Title or Position: ADMINISTRATOR
Credential:
Phone: 757-792-7164