Provider Demographics
NPI:1215093141
Name:QUALITY PERSONAL CARE
Entity type:Organization
Organization Name:QUALITY PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-397-0099
Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:SUITE 2501
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3836
Mailing Address - Country:US
Mailing Address - Phone:336-397-0099
Mailing Address - Fax:336-397-0097
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:SUITE 2501
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3836
Practice Address - Country:US
Practice Address - Phone:336-397-0099
Practice Address - Fax:336-397-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2210251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409252Medicaid