Provider Demographics
NPI:1245587146
Name:ADULT QUALITY CARE HOMES, INC.
Entity Type:Organization
Organization Name:ADULT QUALITY CARE HOMES, INC.
Other - Org Name:A COUNTRY RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:LARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-622-1348
Mailing Address - Street 1:4869 NW 124TH WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3464
Mailing Address - Country:US
Mailing Address - Phone:954-415-1106
Mailing Address - Fax:
Practice Address - Street 1:14327 69TH DR N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33418-7240
Practice Address - Country:US
Practice Address - Phone:561-622-1348
Practice Address - Fax:561-828-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5699310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility