MEDICARE: ASSURANCE & QUALITY COMPANION CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1316721921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURANCE & QUALITY COMPANION CARE SERVICES

Provider Business Mailing Address
First Line	:	62 OAK GROVE LN
Second Line	:
City	:	QUINCY
State	:	FL
Zip	:	32351-8895
Country	:	US
Telephone Number	:	850-528-0399
Fax Number	:	850-724-1717

Provider Business Practice Location Address
First Line	:	62 OAK GROVE LN
Second Line	:
City	:	QUINCY
State	:	FL
Zip	:	32351-8895
Country	:	US
Telephone Number	:	850-528-0399
Fax Number	:	850-724-1717

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. NIKESHA S THOMAS
Credential	:
Telephone Number	:	850-528-0399

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	08/23/2023

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