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General NPI Number Information
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NPI Number | 1164722211
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Entity Type | Organization
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Legal Business Name | HOLIDAY QUALITY CARE SERVICES INC.
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 17270 89TH PL N
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-1744
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Country | US
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Telephone | 561-784-7414
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Fax | 561-791-3211
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Provider Business Mailing Address
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Address Line | 17270 89TH PL N
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-1744
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Country | US
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Telephone | 561-784-7414
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Fax | 561-791-3211
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Authorized Official
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Title or Position | C.EO./WAIVER SUPPORT COORDINATOR
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Name | MRS. JUDY DIANE HOLIDAY
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Credential |
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Telephone | 561-784-7414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 676963296
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License Number State | FL
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