Provider Demographics
NPI:1770517195
Name:QUALITY CARE COMMUNITY SERVICES INC.
Entity type:Organization
Organization Name:QUALITY CARE COMMUNITY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:YOLANDA
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:757-686-4496
Mailing Address - Street 1:3026 TYRE NECK RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-4500
Mailing Address - Country:US
Mailing Address - Phone:757-686-4496
Mailing Address - Fax:757-686-8837
Practice Address - Street 1:3026 TYRE NECK RD
Practice Address - Street 2:SUITE E
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-4500
Practice Address - Country:US
Practice Address - Phone:757-686-4496
Practice Address - Fax:757-686-8837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA659251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010070708Medicare UPIN