Provider Demographics
NPI:1366281438
Name:SENIORS FIRST QUALITY HOME CARE LLC
Entity type:Organization
Organization Name:SENIORS FIRST QUALITY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANGELA
Authorized Official - Middle Name:RENORDA
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-365-8628
Mailing Address - Street 1:753 CREEK BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6667
Mailing Address - Country:US
Mailing Address - Phone:678-365-8628
Mailing Address - Fax:
Practice Address - Street 1:753 CREEK BOTTOM RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-6667
Practice Address - Country:US
Practice Address - Phone:678-939-4744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care