MEDICARE: QUALIS HOME HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1003607821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALIS HOME HEALTH SERVICES

Provider Business Mailing Address
First Line	:	4300 RIDGEWOOD CENTER DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-5307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4810 SAINT BARNABAS RD STE 204
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-4604
Country	:	US
Telephone Number	:	410-246-6528
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ZAKEVIA D GREEN
Credential	:	PHD
Telephone Number	:	703-762-6855

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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Directions to “QUALIS HOME HEALTH SERVICES ” Practice Location

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