Provider Demographics
NPI:1003863747
Name:QUALITY HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:QUALITY HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRICEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-556-5646
Mailing Address - Street 1:8140 NW 155 STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5847
Mailing Address - Country:US
Mailing Address - Phone:305-556-5646
Mailing Address - Fax:305-556-5647
Practice Address - Street 1:8140 NW 155TH STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5847
Practice Address - Country:US
Practice Address - Phone:305-556-5646
Practice Address - Fax:305-556-5647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992077251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108266Medicare ID - Type UnspecifiedHOMEHEALTHAGENCY