Provider Demographics
NPI:1184703589
Name:QUALITY HOME CARE SERVICES
Entity type:Organization
Organization Name:QUALITY HOME CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHAWN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FLOURNOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-285-3388
Mailing Address - Street 1:3607 BEATTIES FORD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-3249
Mailing Address - Country:US
Mailing Address - Phone:704-394-8968
Mailing Address - Fax:704-394-8967
Practice Address - Street 1:3607 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-3249
Practice Address - Country:US
Practice Address - Phone:704-394-8968
Practice Address - Fax:704-394-8967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X, 175T00000X, 207R00000X, 251S00000X, 261QP2300X, 363LP2300X
NC870442251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11997122OtherHEALTHY BLUE OF NC (MEDICAID - LESLIE WARE)
NC13014156OtherMULTIPLAN - LESLIE WARE
NC6022957OtherAETNA
NC1245236249Medicaid
NC2628388OtherWELLCARE
NC5561347OtherAETNA - LESLIE WARE
NC4785515OtherCIGNA - DR. ALICIA HOWARD
NCP10007481725OtherCAROLINA COMPLETE HEALTH - LESLIE WARE