Provider Demographics
NPI:1720230311
Name:QUINTESSENCE HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:QUINTESSENCE HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ABOSEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSUNMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-262-5669
Mailing Address - Street 1:15719 ENSLEIGH LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3235
Mailing Address - Country:US
Mailing Address - Phone:301-262-5669
Mailing Address - Fax:301-576-6043
Practice Address - Street 1:15719 ENSLEIGH LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3235
Practice Address - Country:US
Practice Address - Phone:301-262-5669
Practice Address - Fax:301-576-6043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2627251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health