Provider Demographics
NPI:1942685078
Name:QUALITY CARE SERVICE LLC
Entity Type:Organization
Organization Name:QUALITY CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:251-554-5393
Mailing Address - Street 1:12090 COUNTY -ROAD 138-B
Mailing Address - Street 2:
Mailing Address - City:BAYMINETT
Mailing Address - State:AL
Mailing Address - Zip Code:36507
Mailing Address - Country:US
Mailing Address - Phone:251-554-5393
Mailing Address - Fax:251-937-5784
Practice Address - Street 1:12090 COUNTY ROAD 138 # B
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-6100
Practice Address - Country:US
Practice Address - Phone:251-554-5393
Practice Address - Fax:251-937-5784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUALITY CARE SERVICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health