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General NPI Number Information
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NPI Number | 1255041216
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Entity Type | Organization
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Legal Business Name | QUALITY CARE SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 4505 GEORGE WASHINGTON HWY
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City | PORTSMOUTH
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State | VA
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Zip | 23702-2403
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Country | US
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Telephone | 757-956-6200
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Fax | 757-410-4210
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Provider Business Mailing Address
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Address Line | 4505 GEORGE WASHINGTON HWY
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City | PORTSMOUTH
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State | VA
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Zip | 23702-2403
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Country | US
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Telephone | 757-956-6200
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Fax | 757-410-4210
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Authorized Official
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Title or Position | MANAGER
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Name | CASHUNDA SHANIEL HOWARD
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Credential |
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Telephone | 757-532-6998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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