Provider Demographics
NPI:1457885675
Name:QUALITY CARE HOME HEALTH
Entity Type:Organization
Organization Name:QUALITY CARE HOME HEALTH
Other - Org Name:SHAKIEA JOHNSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKIEA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-549-3041
Mailing Address - Street 1:49 GREEN TIMBER LOOP
Mailing Address - Street 2:
Mailing Address - City:PURVIS
Mailing Address - State:MS
Mailing Address - Zip Code:39475-3456
Mailing Address - Country:US
Mailing Address - Phone:601-549-3041
Mailing Address - Fax:
Practice Address - Street 1:49 GREEN TIMBER LOOP
Practice Address - Street 2:
Practice Address - City:PURVIS
Practice Address - State:MS
Practice Address - Zip Code:39475-3456
Practice Address - Country:US
Practice Address - Phone:601-549-3041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health