Provider Demographics
NPI:1750553558
Name:GOOD QUALITY HOME HEALTH CARE INC
Entity type:Organization
Organization Name:GOOD QUALITY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-820-1277
Mailing Address - Street 1:2100 W 76TH ST
Mailing Address - Street 2:406
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5539
Mailing Address - Country:US
Mailing Address - Phone:305-820-1277
Mailing Address - Fax:305-820-1279
Practice Address - Street 1:2100 W 76TH ST
Practice Address - Street 2:406
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5539
Practice Address - Country:US
Practice Address - Phone:305-820-1277
Practice Address - Fax:305-820-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPPLIED FOR251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDING MEDICARE#OtherPENDING MEDICARE#