Provider Demographics
NPI:1023634573
Name:CQC HEALTHCARE, LLC
Entity type:Organization
Organization Name:CQC HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CORRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TURPIN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:301-710-8646
Mailing Address - Street 1:1100 NEW JERSEY AVE SE # 2145
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 NEW JERSEY AVE SE # 2145
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3302
Practice Address - Country:US
Practice Address - Phone:202-743-4274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-21
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)