Basic Information
| Provider Information | |||||||||
| NPI: | 1639175839 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTH QUEST HOME CARE, INC. (CERTIFIED) | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | HUDSON VALLEY HOME CARE, INC. (CERTIFIED) | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2649 SOUTH ROAD | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126015252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454714243 | ||||||||
| FaxNumber: | 8454710642 | ||||||||
| Practice Location | |||||||||
| Address1: | 2649 SOUTH ROAD | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126015252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454714243 | ||||||||
| FaxNumber: | 8454710642 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2005 | ||||||||
| LastUpdateDate: | 11/10/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | DEBARBA | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | JOSEPH | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2033146990 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 11/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WH0200X | 9004L001 | NY | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Home Health | 251E00000X | 9004L001 | NY | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 03006246 | 05 | NY | MEDICAID | 00846951 | 05 | NY | MEDICAID | 00944761 | 05 | NY | MEDICAID |