Provider Demographics
NPI:1285408757
Name:QWEST PERSONAL CARE INC
Entity type:Organization
Organization Name:QWEST PERSONAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-523-9448
Mailing Address - Street 1:3500 DEPAUW BLVD # 10819
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1170
Mailing Address - Country:US
Mailing Address - Phone:888-523-9448
Mailing Address - Fax:
Practice Address - Street 1:3500 DEPAUW BLVD # 10819
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1170
Practice Address - Country:US
Practice Address - Phone:888-523-9448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care