Basic Information
| Provider Information | |||||||||
| NPI: | 1861678450 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUALITY CARE FAMILY SUPPORT SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1015 CENTRAL AVE. SUITE 210-C | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700015777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043197402 | ||||||||
| FaxNumber: | 5044699394 | ||||||||
| Practice Location | |||||||||
| Address1: | 1015 CENTRAL AVE. SUITE 210-C | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700015777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043197402 | ||||||||
| FaxNumber: | 5044699394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2008 | ||||||||
| LastUpdateDate: | 01/14/2008 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MORRIS-LANDRY | ||||||||
| AuthorizedOfficialFirstName: | KENYA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR/DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5043197402 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | GRADUATE SOCIAL WORK | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302F00000X | LA | Y | Managed Care Organizations | Exclusive Provider Organization |
No ID Information.