Provider Demographics
NPI:1982145983
Name:PRO QUALITY HOME CARE INC
Entity Type:Organization
Organization Name:PRO QUALITY HOME CARE INC
Other - Org Name:PRO QUALITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:HERIBERTO
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-815-8505
Mailing Address - Street 1:16200 SW PACIFIC HWY
Mailing Address - Street 2:148
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-4053
Mailing Address - Country:US
Mailing Address - Phone:541-815-8505
Mailing Address - Fax:503-521-7493
Practice Address - Street 1:16200 SW PACIFIC HWY
Practice Address - Street 2:148
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-4053
Practice Address - Country:US
Practice Address - Phone:541-815-8505
Practice Address - Fax:503-521-7493
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRO QUALITY HOME CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization