Provider Demographics
NPI:1396553236
Name:QUALITY ADULT HOME CARE
Entity type:Organization
Organization Name:QUALITY ADULT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:MARTHA
Authorized Official - Last Name:NAZZIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:976-395-6111
Mailing Address - Street 1:835 NE JOSEPHINE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-1734
Mailing Address - Country:US
Mailing Address - Phone:971-348-5108
Mailing Address - Fax:971-864-6968
Practice Address - Street 1:835 NE JOSEPHINE ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-1734
Practice Address - Country:US
Practice Address - Phone:971-348-5108
Practice Address - Fax:971-864-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty