Provider Demographics
NPI:1932583176
Name:QUALITY FAMILY CARE HOME CARE SERVICES
Entity Type:Organization
Organization Name:QUALITY FAMILY CARE HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-242-9450
Mailing Address - Street 1:2300 WEST SAMPLE RD SUITE 210
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3048
Mailing Address - Country:US
Mailing Address - Phone:754-227-7175
Mailing Address - Fax:754-227-7177
Practice Address - Street 1:2300 WEST SAMPLE RD SUITE 210
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33073-3048
Practice Address - Country:US
Practice Address - Phone:754-227-7175
Practice Address - Fax:754-227-7177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211496251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003786300Medicaid