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General NPI Number Information
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NPI Number | 1881678886
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Entity Type | Organization
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Legal Business Name | CQI HOMECARE INC
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 520 E WILSON AVE STE 230
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City | GLENDALE
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State | CA
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Zip | 91206
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Country | US
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Telephone | 818-549-4830
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Fax | 818-549-4832
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Provider Business Mailing Address
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Address Line | 520 E WILSON AVE STE 230
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City | GLENDALE
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State | CA
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Zip | 91206
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Country | US
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Telephone | 818-549-4830
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Fax | 818-549-4832
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Authorized Official
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Title or Position | CEO ADMINISTRATOR
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Name | NENA BASICAL VILLANIA
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Credential | RN
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Telephone | 818-549-4830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State | CA
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