=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346846466
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASSURED QUALITY CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2020
-----------------------------------------------------
Last Update Date | 12/06/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3015 N OCEAN BLVD STE 116A
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-7344
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-695-9001
-----------------------------------------------------
Fax | 305-256-8085
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3015 N OCEAN BLVD STE 116A
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-7344
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-695-9001
-----------------------------------------------------
Fax | 305-256-8085
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ARKIM SIMS-MORGAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-695-9001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------