Provider Demographics
NPI:1982296570
Name:QUALITY PERSONAL HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:QUALITY PERSONAL HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-408-0797
Mailing Address - Street 1:3743 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-1676
Mailing Address - Country:US
Mailing Address - Phone:317-408-0797
Mailing Address - Fax:317-271-6450
Practice Address - Street 1:3743 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-1676
Practice Address - Country:US
Practice Address - Phone:317-408-0797
Practice Address - Fax:317-271-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health