MEDICARE: QUALITYCARE HEALTH SERVICES CORPORATION

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	261QA0600X	Adult Day Care Clinic/Center		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033241690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITYCARE HEALTH SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	1825 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2501
Country	:	US
Telephone Number	:	213-413-6966
Fax Number	:	213-413-5276

Provider Business Practice Location Address
First Line	:	1825 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2501
Country	:	US
Telephone Number	:	213-413-6966
Fax Number	:	213-413-5276

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MRS. ELIZABETH A SIQUIAN
Credential	:	RN
Telephone Number	:	213-413-6966

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	08/22/2020

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Directions to “QUALITYCARE HEALTH SERVICES CORPORATION ” Practice Location

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