Provider Demographics
NPI:1851969356
Name:PERSONAL QUALITY PRIVATE DUTY SITTING SERVICES LLLP
Entity Type:Organization
Organization Name:PERSONAL QUALITY PRIVATE DUTY SITTING SERVICES LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KANIESHA
Authorized Official - Middle Name:LOVETTA
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-499-4340
Mailing Address - Street 1:PO BOX 115359
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-8359
Mailing Address - Country:US
Mailing Address - Phone:678-499-4340
Mailing Address - Fax:
Practice Address - Street 1:2013 COX CT
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-2485
Practice Address - Country:US
Practice Address - Phone:678-499-4340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-12
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health