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General NPI Number Information
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NPI Number | 1093540890
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Entity Type | Organization
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Legal Business Name | CRQ HOME CARE LLC
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 606 SW 3RD AVE
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City | OCALA
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State | FL
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Zip | 34471-0930
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Country | US
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Telephone | 352-622-6447
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Fax |
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Provider Business Mailing Address
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Address Line | 2294 E MARCIA ST
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City | INVERNESS
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State | FL
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Zip | 34453-9532
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Country | US
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Telephone | 352-622-6447
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Fax | 352-249-1260
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Authorized Official
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Title or Position | MGRM
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Name | CAROLYN QUINTANILLA
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Credential |
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Telephone | 352-697-2573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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