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Organization

EXCLUSIVE ESTATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
QUAVANTI FLOYD CMA, NA, FIRST AID (CEO)
(334) 314-3868
Entity
Organization

Contact information

Practice address
1931 KINGSBURY DR, MONTGOMERY, AL 36106-3409
(334) 314-3868
(334) 398-8332
Mailing address
1931 KINGSBURY DR, MONTGOMERY, AL 36106-3409
(334) 314-3868
(334) 398-8332

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202100000202
OPEN
AL
Enumeration date
01/12/2021
Last updated
01/12/2021
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