Provider Demographics
NPI:1396306296
Name:R.A. QUARSHIE HEALTHCARE LLC
Entity type:Organization
Organization Name:R.A. QUARSHIE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADELAIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-486-1894
Mailing Address - Street 1:10560 MAIN ST STE 98-12
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7182
Mailing Address - Country:US
Mailing Address - Phone:703-825-4508
Mailing Address - Fax:240-428-6009
Practice Address - Street 1:10560 MAIN ST STE 98-12
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7182
Practice Address - Country:US
Practice Address - Phone:703-825-4508
Practice Address - Fax:240-428-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-23
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3227-03-011OtherDEPARTMENT OF BEHAVIORAL HEALTH