Provider Demographics
NPI:1962188334
Name:QUEBA HOME HEALTH SYSTEM LLC
Entity type:Organization
Organization Name:QUEBA HOME HEALTH SYSTEM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:QUEBA
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NONGMISEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-686-4331
Mailing Address - Street 1:1715 INDIAN WOOD CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-4055
Mailing Address - Country:US
Mailing Address - Phone:567-686-4331
Mailing Address - Fax:
Practice Address - Street 1:5902 SOUTHWYCK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614
Practice Address - Country:US
Practice Address - Phone:567-686-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health