Provider Demographics
NPI:1881678886
Name:CQI HOMECARE INC
Entity Type:Organization
Organization Name:CQI HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NENA
Authorized Official - Middle Name:BASICAL
Authorized Official - Last Name:VILLANIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-549-4830
Mailing Address - Street 1:520 E WILSON AVE
Mailing Address - Street 2:STE 230
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206
Mailing Address - Country:US
Mailing Address - Phone:818-549-4830
Mailing Address - Fax:818-549-4832
Practice Address - Street 1:520 E WILSON AVE
Practice Address - Street 2:STE 230
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206
Practice Address - Country:US
Practice Address - Phone:818-549-4830
Practice Address - Fax:818-549-4832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
058119Medicare ID - Type Unspecified