MEDICARE: QUALITY PERSONAL HOME HEALTH CARE 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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1548123235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY PERSONAL HOME HEALTH CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	3743 COMMERCIAL DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-1676
Country	:	US
Telephone Number	:	317-408-0797
Fax Number	:	317-408-0797

Provider Business Practice Location Address
First Line	:	3743 COMMERCIAL DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-1676
Country	:	US
Telephone Number	:	317-408-0797
Fax Number	:	317-408-0797

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	NATHANIEL SAMBA
Credential	:
Telephone Number	:	317-408-0797

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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