MEDICARE: QUILTED CARE CHOICES, 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	251E00000X	Home Health Agency	010167	TX

General Provider Information

NPI Number	:	1346491479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUILTED CARE CHOICES, LLC

Provider Business Mailing Address
First Line	:	5353 WYOMING BLVD NE
Second Line	:	SUITE A
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-3132
Country	:	US
Telephone Number	:	505-797-8735
Fax Number	:	505-797-9003

Provider Business Practice Location Address
First Line	:	2502 WESTERLAND DR
Second Line	:	ATTN: HOME HEALTH
City	:	HOUSTON
State	:	TX
Zip	:	77063-2202
Country	:	US
Telephone Number	:	713-780-3710
Fax Number	:	713-780-3718

Authorized Official
Title or Position	:	DIR OF MEDICARE & MEDICAID SERVICES
Name	:	MR. BRIAN T BYRNE
Credential	:
Telephone Number	:	505-797-8735

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	10/07/2008

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