Provider Demographics
NPI:1467164483
Name:CQA CARE LLC
Entity Type:Organization
Organization Name:CQA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-219-2302
Mailing Address - Street 1:5515 FRIPP CT NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8047
Mailing Address - Country:US
Mailing Address - Phone:404-219-2302
Mailing Address - Fax:
Practice Address - Street 1:5515 FRIPP CT NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-8047
Practice Address - Country:US
Practice Address - Phone:404-219-2302
Practice Address - Fax:770-529-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care