Provider Demographics
NPI:1376845115
Name:QUALITY CARE ASSISTED LIVING FACILITY, INC.
Entity Type:Organization
Organization Name:QUALITY CARE ASSISTED LIVING FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:BANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-294-3508
Mailing Address - Street 1:10215 NW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5810
Mailing Address - Country:US
Mailing Address - Phone:954-255-1381
Mailing Address - Fax:954-255-6840
Practice Address - Street 1:10215 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-5810
Practice Address - Country:US
Practice Address - Phone:954-255-1381
Practice Address - Fax:954-255-6840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL949496310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility