=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184643272
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUEST HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2006
-----------------------------------------------------
Last Update Date | 08/11/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 627 W COLLEGE ST
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-5222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-488-7442
-----------------------------------------------------
Fax | 817-251-4663
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 627 W COLLEGE ST
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-5222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-488-7442
-----------------------------------------------------
Fax | 817-251-4663
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | FIIFI ADAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 817-488-7442
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 008035
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------