Provider Demographics
NPI:1083364855
Name:EXQUISITE HOMECARE AND TRANSPORTATION LLC
Entity Type:Organization
Organization Name:EXQUISITE HOMECARE AND TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RASHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-756-9875
Mailing Address - Street 1:1515 5TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-1367
Mailing Address - Country:US
Mailing Address - Phone:309-592-3005
Mailing Address - Fax:
Practice Address - Street 1:1515 5TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-1367
Practice Address - Country:US
Practice Address - Phone:309-592-3005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health