Provider Demographics
NPI:1598528580
Name:QUISQUEYA HOMECARE LLC
Entity Type:Organization
Organization Name:QUISQUEYA HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-430-8170
Mailing Address - Street 1:1000 W PEMBROKE RD STE 314
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2181
Mailing Address - Country:US
Mailing Address - Phone:561-430-8170
Mailing Address - Fax:
Practice Address - Street 1:1000 W PEMBROKE RD STE 314
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2181
Practice Address - Country:US
Practice Address - Phone:561-430-8170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health