Provider Demographics
NPI:1164796082
Name:QUALITY HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:QUALITY HEALTHCARE SERVICES, INC.
Other - Org Name:QUALITY HEALTHCARE SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:NERI
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-530-1381
Mailing Address - Street 1:944 S WAKEFIELD ST STE 105
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-3049
Mailing Address - Country:US
Mailing Address - Phone:703-530-1381
Mailing Address - Fax:703-530-1382
Practice Address - Street 1:944 S WAKEFIELD ST STE 105
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-3049
Practice Address - Country:US
Practice Address - Phone:703-530-1381
Practice Address - Fax:703-530-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
VAHCO-12619253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1013170836Medicaid