Provider Demographics
NPI:1033753199
Name:GQ HOME CARE & ADULT SERVICES
Entity Type:Organization
Organization Name:GQ HOME CARE & ADULT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-707-7459
Mailing Address - Street 1:21 LACKAWANNA PL APT 552
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2961
Mailing Address - Country:US
Mailing Address - Phone:973-885-3381
Mailing Address - Fax:973-372-0162
Practice Address - Street 1:531-533 SOUTH ORANGE AVENUE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-0710
Practice Address - Country:US
Practice Address - Phone:973-707-7459
Practice Address - Fax:973-372-0162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty