Provider Demographics
NPI:1396414785
Name:QUALICARE MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:QUALICARE MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:POCHOLO
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-800-3444
Mailing Address - Street 1:1050 LAKES DR STE 225
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2910
Mailing Address - Country:US
Mailing Address - Phone:626-800-3444
Mailing Address - Fax:626-800-3487
Practice Address - Street 1:1050 LAKES DR STE 225
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2910
Practice Address - Country:US
Practice Address - Phone:626-800-3444
Practice Address - Fax:626-800-3487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health