Provider Demographics
NPI:1104885318
Name:QUALITY HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:QUALITY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIQUIS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:626-966-6893
Mailing Address - Street 1:3218 E HOLT AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-2364
Mailing Address - Country:US
Mailing Address - Phone:626-966-6893
Mailing Address - Fax:626-966-7344
Practice Address - Street 1:3218 E HOLT AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-2364
Practice Address - Country:US
Practice Address - Phone:626-966-6893
Practice Address - Fax:626-966-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000847251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57478FMedicaid
CAHHA57478FMedicaid