Healthcare Provider Details

I. General information

NPI: 1255001699
Provider Name (Legal Business Name): QUALITY HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W125S7554 COVENTRY LN
MUSKEGO WI
53150-4019
US

IV. Provider business mailing address

W125S7554 COVENTRY LN
MUSKEGO WI
53150-4019
US

V. Phone/Fax

Practice location:
  • Phone: 414-416-4277
  • Fax: 414-425-5138
Mailing address:
  • Phone: 414-416-4277
  • Fax: 414-425-4871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: MS. KIM MARIE JROLF
Title or Position: OWNER
Credential: CNA
Phone: 414-416-4277