Provider Demographics
NPI:1376584177
Name:QUALITY HEALTH CARE, LLC
Entity Type:Organization
Organization Name:QUALITY HEALTH CARE, LLC
Other - Org Name:CARE LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP BUSINESS MGR
Authorized Official - Prefix:
Authorized Official - First Name:S
Authorized Official - Middle Name:WENDY
Authorized Official - Last Name:MCENTIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-737-0881
Mailing Address - Street 1:1380 S DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5215
Mailing Address - Country:US
Mailing Address - Phone:405-737-0881
Mailing Address - Fax:405-737-0899
Practice Address - Street 1:5512 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-4511
Practice Address - Country:US
Practice Address - Phone:405-632-2318
Practice Address - Fax:405-632-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH5533-5533314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37-5503Medicare ID - Type Unspecified