Provider Demographics
NPI:1821070269
Name:QUALITY CARE HOME HEALTH SPECIALIST INC.
Entity Type:Organization
Organization Name:QUALITY CARE HOME HEALTH SPECIALIST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-869-0131
Mailing Address - Street 1:127 N LANG AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2122
Mailing Address - Country:US
Mailing Address - Phone:626-869-0131
Mailing Address - Fax:626-869-0141
Practice Address - Street 1:127 N LANG AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2122
Practice Address - Country:US
Practice Address - Phone:626-869-0131
Practice Address - Fax:626-869-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA557792Medicare Oscar/Certification