Provider Demographics
NPI:1255041216
Name:QUALITY CARE SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:QUALITY CARE SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASHUNDA
Authorized Official - Middle Name:SHANIEL
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-532-6998
Mailing Address - Street 1:4505 GEORGE WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23702-2403
Mailing Address - Country:US
Mailing Address - Phone:757-956-6200
Mailing Address - Fax:757-410-4210
Practice Address - Street 1:4505 GEORGE WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23702-2403
Practice Address - Country:US
Practice Address - Phone:757-956-6200
Practice Address - Fax:757-410-4210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No253Z00000XAgenciesIn Home Supportive Care
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility