Organization
QUALITY CARE AT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRICE CLARK (OWNER/ADMINISTRATOR)
(336) 866-9248
Entity
Organization
Contact information
Practice address
559 SOUTHLAKE BLVD, NORTH CHESTERFIELD, VA 23236-3073
(804) 475-2904
Mailing address
559 SOUTHLAKE BLVD, NORTH CHESTERFIELD, VA 23236-3073
(804) 475-2904
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
11/07/2019
Last updated
02/27/2023
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