Provider Demographics
NPI:1477837284
Name:QUALITY CARE HOME HEALTH INC
Entity Type:Organization
Organization Name:QUALITY CARE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DONOVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-775-9426
Mailing Address - Street 1:3771 RAMSEY ST STE 109-237
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-7675
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3143 UNION CHAPEL RD
Practice Address - Street 2:A
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-7932
Practice Address - Country:US
Practice Address - Phone:910-775-9426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NCHC3928251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418786Medicaid
NC6602308Medicaid