Provider Demographics
NPI:1073091344
Name:QUALITY PRIVATE DUTY LLC
Entity Type:Organization
Organization Name:QUALITY PRIVATE DUTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENYETTA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-746-8149
Mailing Address - Street 1:2844 LIVERNOIS RD UNIT 4233
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-7779
Mailing Address - Country:US
Mailing Address - Phone:586-746-8149
Mailing Address - Fax:586-991-6969
Practice Address - Street 1:45155 FOX LN W
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317-5039
Practice Address - Country:US
Practice Address - Phone:586-746-8149
Practice Address - Fax:586-991-6969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health