Provider Demographics
NPI:1356905822
Name:QUANTUM VENTURES
Entity type:Organization
Organization Name:QUANTUM VENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOBES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-467-0401
Mailing Address - Street 1:18055 FISH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-8624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18055 FISH LAKE RD
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-8624
Practice Address - Country:US
Practice Address - Phone:248-467-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care