Provider Demographics
NPI:1245794825
Name:ASSISTED QUALITY GROUP, INC.
Entity Type:Organization
Organization Name:ASSISTED QUALITY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-896-3249
Mailing Address - Street 1:8734 SW 213TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-7303
Mailing Address - Country:US
Mailing Address - Phone:305-896-3249
Mailing Address - Fax:786-250-5449
Practice Address - Street 1:8734 SW 213TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-7303
Practice Address - Country:US
Practice Address - Phone:305-896-3249
Practice Address - Fax:786-250-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101943800Medicaid
FL1245794825Medicaid