Provider Demographics
NPI:1407987373
Name:CHILDREN & ADOLESCENTS QUALITY CARE
Entity Type:Organization
Organization Name:CHILDREN & ADOLESCENTS QUALITY CARE
Other - Org Name:TOLEDO PEDIATRIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:I
Authorized Official - Last Name:KASHK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-472-7755
Mailing Address - Street 1:4126 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-2504
Mailing Address - Country:US
Mailing Address - Phone:419-472-7755
Mailing Address - Fax:419-472-8811
Practice Address - Street 1:4126 N HOLLAND SYLVANIA RD
Practice Address - Street 2:SUITE 140
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-2504
Practice Address - Country:US
Practice Address - Phone:419-472-7755
Practice Address - Fax:419-472-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073548208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2052013Medicaid