Provider Demographics
NPI:1952984619
Name:GIFTED QUALITY CARE
Entity Type:Organization
Organization Name:GIFTED QUALITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STNA
Authorized Official - Prefix:
Authorized Official - First Name:TANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-954-6954
Mailing Address - Street 1:1312 1ST AVE APT B
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-4129
Mailing Address - Country:US
Mailing Address - Phone:513-954-6954
Mailing Address - Fax:
Practice Address - Street 1:1312 1ST AVE APT B
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-4129
Practice Address - Country:US
Practice Address - Phone:513-954-6954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4650818OtherOHIO SECRETARY OF STATE