Provider Demographics
NPI:1588201826
Name:AT HOME QUALITY CARE
Entity Type:Organization
Organization Name:AT HOME QUALITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR BILLING MANAGER/CONTRACTS
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS-BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-223-1941
Mailing Address - Street 1:611 ROUTE 46 WEST, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-1307
Mailing Address - Country:US
Mailing Address - Phone:551-223-1941
Mailing Address - Fax:201-621-4325
Practice Address - Street 1:901 WEST GOVERNOR ROAD
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2219
Practice Address - Country:US
Practice Address - Phone:570-587-4700
Practice Address - Fax:201-621-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024949780002Medicaid