Basic Information
| Provider Information | |||||||||
| NPI: | 1124386743 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | QUALITY PRIVATE CARE LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | QIALITY PRIVATE CARE LLC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 42536 HAYES RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CLINTON TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480386766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862869644 | ||||||||
| FaxNumber: | 5862869647 | ||||||||
| Practice Location | |||||||||
| Address1: | 42536 HAYES RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CLINTON TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480386766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862869644 | ||||||||
| FaxNumber: | 5862869647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2012 | ||||||||
| LastUpdateDate: | 05/02/2012 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SAVICH | ||||||||
| AuthorizedOfficialFirstName: | TATJANA | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5862869644 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MSA,OTRL | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 253Z00000X | Y | Agencies | In Home Supportive Care |
No ID Information.