# MQ LONG TERM CARE AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629602933
- **Authorized official:** MRS. AMANDA PHAN (MANAGER)
- **Authorized official phone:** (720) 933-5099

## Contact information

- **Practice address:** 1700 WADSWORTH BLVD, LAKEWOOD, CO 80214-5256
- **Practice address phone:** (303) 238-1488
- **Practice address fax:** (303) 238-1459
- **Mailing address:** 1700 WADSWORTH BLVD, LAKEWOOD, CO 80214-5256
- **Mailing address phone:** (303) 238-1488
- **Mailing address fax:** (303) 238-1459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/25/2020
- **Last updated:** 02/25/2020