MEDICARE: A & S QUALITY CARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	251X00000X	Supports Brokerage Agency
3	251B00000X	Case Management Agency

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	:	1245667104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A & S QUALITY CARE

Provider Business Mailing Address
First Line	:	9314 LAKE FISCHER BLVD
Second Line	:
City	:	GOTHA
State	:	FL
Zip	:	34734-5203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9314 LAKE FISCHER BLVD
Second Line	:
City	:	GOTHA
State	:	FL
Zip	:	34734-5203
Country	:	US
Telephone Number	:	407-592-3832
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHIRLEY SIMMONS
Credential	:
Telephone Number	:	407-592-3832

Provider Enumeration Date	:	10/08/2013
Last Update Date	:	10/08/2013

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Directions to “A & S QUALITY CARE ” Practice Location

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