Provider Demographics
NPI:1295081735
Name:QUALITY CARE SERVICES LLC
Entity type:Organization
Organization Name:QUALITY CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-649-9082
Mailing Address - Street 1:215 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST PRAIRIE
Mailing Address - State:MO
Mailing Address - Zip Code:63845-1123
Mailing Address - Country:US
Mailing Address - Phone:573-649-9082
Mailing Address - Fax:573-649-9626
Practice Address - Street 1:215 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63845-1123
Practice Address - Country:US
Practice Address - Phone:573-649-9082
Practice Address - Fax:573-649-9626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0011310253Z00000X
MO0010768253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1902191471Medicaid