Provider Demographics
NPI:1184242729
Name:QUALUCARE LLC
Entity type:Organization
Organization Name:QUALUCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-593-9568
Mailing Address - Street 1:418 MONTEREY CIR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-8244
Mailing Address - Country:US
Mailing Address - Phone:404-593-9568
Mailing Address - Fax:
Practice Address - Street 1:3707 MAIN ST STE 16
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-3544
Practice Address - Country:US
Practice Address - Phone:404-593-9568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care