1639175839 NPI number — HEALTH QUEST HOME CARE, INC. (CERTIFIED)

Table of content: (NPI 1639175839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639175839 NPI number — HEALTH QUEST HOME CARE, INC. (CERTIFIED)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH QUEST HOME CARE, INC. (CERTIFIED)
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HUDSON VALLEY HOME CARE, INC. (CERTIFIED)
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639175839
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2649 SOUTH ROAD
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12601-5252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-471-4243
Provider Business Mailing Address Fax Number:
845-471-0642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2649 SOUTH ROAD
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12601-5252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-471-4243
Provider Business Practice Location Address Fax Number:
845-471-0642
Provider Enumeration Date:
06/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DEBARBA
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
203-314-6990

Provider Taxonomy Codes

  • Taxonomy code: 163WH0200X , with the licence number:  9004L001 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 9004L001 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03006246 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00846951 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00944761 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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