Healthcare Provider Details

I. General information

NPI: 1760760995
Provider Name (Legal Business Name): QUALITY HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3928 S LAKE DR
SAINT FRANCIS WI
53235-5227
US

IV. Provider business mailing address

PO BOX 210221
MILWAUKEE WI
53221-8004
US

V. Phone/Fax

Practice location:
  • Phone: 414-423-9499
  • Fax: 414-423-9497
Mailing address:
  • Phone: 414-423-9499
  • Fax: 414-423-9497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. EDNA MUON GONZAGA
Title or Position: OWNER
Credential: RN
Phone: 414-423-9499