Provider Demographics
NPI:1861867616
Name:A & P QUALITY HOME CARE AGENCY, LLC
Entity Type:Organization
Organization Name:A & P QUALITY HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:765-530-8011
Mailing Address - Street 1:37 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47346-1212
Mailing Address - Country:US
Mailing Address - Phone:765-530-8011
Mailing Address - Fax:765-530-8143
Practice Address - Street 1:37 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47346-1212
Practice Address - Country:US
Practice Address - Phone:765-744-7139
Practice Address - Fax:765-530-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN15-013768-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care