Provider Demographics
NPI:1073784757
Name:KING QUALITY HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:KING QUALITY HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADDISON
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:225-293-0100
Mailing Address - Street 1:11748 S HARRELLS FERRY RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2392
Mailing Address - Country:US
Mailing Address - Phone:225-293-0100
Mailing Address - Fax:225-293-0120
Practice Address - Street 1:11748 S HARRELLS FERRY RD
Practice Address - Street 2:SUITE E
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2392
Practice Address - Country:US
Practice Address - Phone:225-293-0100
Practice Address - Fax:225-293-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 15001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health