=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487657854
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUALITY HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2005
-----------------------------------------------------
Last Update Date | 12/13/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1515 S SAM RAYBURN FWY
-----------------------------------------------------
City | SHERMAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75090-8735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-892-9281
-----------------------------------------------------
Fax | 903-870-0580
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1515 S SAM RAYBURN FWY
-----------------------------------------------------
City | SHERMAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75090-8735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-892-9281
-----------------------------------------------------
Fax | 903-870-0580
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/CFO/OWNER
-----------------------------------------------------
Name | DUSTIN EUGENE VANSICKLE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 903-892-9281
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 016727
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------