Provider Demographics
NPI:1326347675
Name:AMORE QUALITY SERVICE
Entity Type:Organization
Organization Name:AMORE QUALITY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID WAIVER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-766-1570
Mailing Address - Street 1:7868 DENHAM RD E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-3007
Mailing Address - Country:US
Mailing Address - Phone:904-766-1570
Mailing Address - Fax:
Practice Address - Street 1:7868 DENHAM RD E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-3007
Practice Address - Country:US
Practice Address - Phone:904-766-1570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL692298896253Z00000X, 385HR2050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253Z00000XMedicaid
FL385H00000XMedicaid