Provider Demographics
NPI:1740441112
Name:ON Q HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:ON Q HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/COO
Authorized Official - Prefix:MISS
Authorized Official - First Name:QUERIDA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-592-1144
Mailing Address - Street 1:2319 123RD PL E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-6908
Mailing Address - Country:US
Mailing Address - Phone:941-592-1144
Mailing Address - Fax:941-981-9065
Practice Address - Street 1:2319 123RD PL E
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-6908
Practice Address - Country:US
Practice Address - Phone:941-592-1144
Practice Address - Fax:941-981-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230642251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health