Provider Demographics
NPI:1518249507
Name:QUALICARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:QUALICARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OGECHI
Authorized Official - Middle Name:CORDICE
Authorized Official - Last Name:EYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-207-5867
Mailing Address - Street 1:1800 SHILOH RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-2418
Mailing Address - Country:US
Mailing Address - Phone:214-207-5867
Mailing Address - Fax:844-250-2460
Practice Address - Street 1:1800 SHILOH RD
Practice Address - Street 2:SUITE 205
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2418
Practice Address - Country:US
Practice Address - Phone:214-207-5867
Practice Address - Fax:844-250-2460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX014493251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health