Provider Demographics
NPI:1477867638
Name:EXQUISITE QUEENS IN- HOME CARE, LLC
Entity Type:Organization
Organization Name:EXQUISITE QUEENS IN- HOME CARE, LLC
Other - Org Name:QUEENS CARE IN HOME 2, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-653-2468
Mailing Address - Street 1:14211 EVENTIDE DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:281-653-2468
Mailing Address - Fax:
Practice Address - Street 1:14211 EVENTIDE DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:281-653-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care