Basic Information
| Provider Information | |||||||||
| NPI: | 1285767806 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUEST THERAPEUTIC SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 461 CANN RD | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193821715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106926362 | ||||||||
| FaxNumber: | 6106920917 | ||||||||
| Practice Location | |||||||||
| Address1: | 461 CANN RD | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193821715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106926362 | ||||||||
| FaxNumber: | 6106920917 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 03/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | MCCLOSKEY | ||||||||
| AuthorizedOfficialFirstName: | SANDRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6106926362 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 235Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225XP0200X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | 2251P0200X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 0018357570001 | 05 | PA | MEDICAID |