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General NPI Number Information
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NPI Number | 1295081735
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Entity Type | Organization
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Legal Business Name | QUALITY CARE SERVICES LLC
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 215 E MAIN ST
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City | EAST PRAIRIE
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State | MO
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Zip | 63845-1123
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Country | US
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Telephone | 573-649-9082
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Fax | 573-649-9626
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Provider Business Mailing Address
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Address Line | 215 E MAIN ST
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City | EAST PRAIRIE
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State | MO
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Zip | 63845-1123
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Country | US
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Telephone | 573-649-9082
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Fax | 573-649-9626
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Authorized Official
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Title or Position | OWNER/RN
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Name | MRS. CATHY ANN JACKSON
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Credential |
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Telephone | 573-649-9082
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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 | 0011310
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License Number State | MO
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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 | 0010768
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License Number State | MO
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