Provider Demographics
NPI:1568837318
Name:QUALICARE HEALTH, LLC
Entity Type:Organization
Organization Name:QUALICARE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE AND ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:SSENTONGO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:781-475-8262
Mailing Address - Street 1:400 W CUMMINGS PARK
Mailing Address - Street 2:SUITE 3715
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6519
Mailing Address - Country:US
Mailing Address - Phone:781-281-0097
Mailing Address - Fax:781-281-1674
Practice Address - Street 1:400 W CUMMINGS PARK
Practice Address - Street 2:SUITE 3715
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6519
Practice Address - Country:US
Practice Address - Phone:781-281-0097
Practice Address - Fax:781-281-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263091251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health