Provider Demographics
NPI:1598038572
Name:QUALITY CARE NURSING AGENCY, LLC
Entity Type:Organization
Organization Name:QUALITY CARE NURSING AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KWADWO
Authorized Official - Middle Name:
Authorized Official - Last Name:KWARTENG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:513-737-6172
Mailing Address - Street 1:6825 MELROSE PL
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-6627
Mailing Address - Country:US
Mailing Address - Phone:513-737-6172
Mailing Address - Fax:
Practice Address - Street 1:6825 MELROSE PL
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-6627
Practice Address - Country:US
Practice Address - Phone:513-737-6172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0067711OtherODJFS MEDICAID PROVIDER NUMBER