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General NPI Number Information
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NPI Number | 1851969356
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Entity Type | Organization
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Legal Business Name | PERSONAL QUALITY PRIVATE DUTY SITTING SERVICES LLLP
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Dates
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Enumeration Date | 06/12/2021
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 2013 COX CT
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City | COLLEGE PARK
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State | GA
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Zip | 30337-2485
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Country | US
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Telephone | 678-499-4340
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 115359
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City | ATLANTA
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State | GA
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Zip | 30310-8359
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Country | US
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Telephone | 678-499-4340
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KANIESHA LOVETTA CLARK
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Credential |
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Telephone | 678-499-4340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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