Provider Demographics
NPI:1447344569
Name:QUALI-CARE HOME HEALTH AGENCY INC
Entity type:Organization
Organization Name:QUALI-CARE HOME HEALTH AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YISSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-232-3979
Mailing Address - Street 1:18001 OLD CUTLER ROAD
Mailing Address - Street 2:SUITE 454
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157
Mailing Address - Country:US
Mailing Address - Phone:305-232-3979
Mailing Address - Fax:305-232-5017
Practice Address - Street 1:9245 SW 158TH LN FL 2
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1804
Practice Address - Country:US
Practice Address - Phone:305-232-3979
Practice Address - Fax:786-558-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299990971251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650766200Medicaid
FL107691Medicare Oscar/Certification