Provider Demographics
NPI:1912190521
Name:QSTAFF INCORPORATED
Entity Type:Organization
Organization Name:QSTAFF INCORPORATED
Other - Org Name:ADVANCED CARE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,MBA
Authorized Official - Phone:281-204-8944
Mailing Address - Street 1:451 HIGHWAY 3 S
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3847
Mailing Address - Country:US
Mailing Address - Phone:281-204-8944
Mailing Address - Fax:281-204-8941
Practice Address - Street 1:451 HIGHWAY 3 S
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3847
Practice Address - Country:US
Practice Address - Phone:281-204-8944
Practice Address - Fax:281-204-8941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QSTAFF INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-27
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011487251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011487OtherLICENSE FOR TEXAS HOSPICE
TX001017923Medicaid
TX001017923Medicaid