Provider Demographics
NPI:1225071996
Name:QUALITY CARE MANAGEMENT OF N CENTRAL FLORIDA,LLC
Entity Type:Organization
Organization Name:QUALITY CARE MANAGEMENT OF N CENTRAL FLORIDA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOLETHER
Authorized Official - Middle Name:ELESTER
Authorized Official - Last Name:CROOMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:386-325-0314
Mailing Address - Street 1:613 SAINT JOHNS AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-4643
Mailing Address - Country:US
Mailing Address - Phone:386-325-0314
Mailing Address - Fax:386-325-0137
Practice Address - Street 1:613 SAINT JOHNS AVE
Practice Address - Street 2:SUITE # 209
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-4643
Practice Address - Country:US
Practice Address - Phone:386-325-0314
Practice Address - Fax:386-325-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty