MEDICARE: QUALITY HOMECARE SERVICES, LLC

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	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1104501287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY HOMECARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	2305 FAIRWAY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-4513
Country	:	US
Telephone Number	:	336-944-3247
Fax Number	:

Provider Business Practice Location Address
First Line	:	2305 FAIRWAY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-4513
Country	:	US
Telephone Number	:	336-944-3247
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PAW OH GAY
Credential	:
Telephone Number	:	336-944-3247

Provider Enumeration Date	:	06/16/2023
Last Update Date	:	05/28/2024

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