Provider Demographics
NPI: | 1053898452 |
---|---|
Name: | QUALITY TOUCH COMMUNITY CARE LLC |
Entity type: | Organization |
Organization Name: | QUALITY TOUCH COMMUNITY CARE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DION |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CASHAW |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 862-295-7447 |
Mailing Address - Street 1: | 57 HIGHWOOD RD |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST ORANGE |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07052-4000 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 862-295-7447 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 46-56 OAKWOOD AVE |
Practice Address - Street 2: | |
Practice Address - City: | ORANGE |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07050 |
Practice Address - Country: | US |
Practice Address - Phone: | 862-295-7447 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-07-27 |
Last Update Date: | 2024-03-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 0646458 | Medicaid |