| Entity Name: | LIFE QUALITY HOME HEALTH CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Oct 1996 (28 years ago) |
| Document Number: | P96000085438 |
| FEI/EIN Number | 650697524 |
| Address: | 5180 WEST ATLANTIC AVE., SUITE 101, DELRAY BEACH, FL, 33484, US |
| Mail Address: | 17146 avenue le rivage, boca raton, FL, 33484, US |
| ZIP code: | 33484 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568461903 | 2005-07-19 | 2011-03-17 | 5180 W ATLANTIC AVE, STE 101, DELRAY BEACH, FL, 334848103, US | 5180 W ATLANTIC AVE, STE 101, DELRAY BEACH, FL, 334848103, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-495-9200 |
| Fax | 5614950210 |
Authorized person
| Name | MR. DAVID SOBLICK |
| Role | PRESIDENT |
| Phone | 5614959200 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 318 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 318 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | R8624 |
| State | FL |
| Issuer | MEDICAID |
| Number | 951847900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SOBLICK DAVID | Agent | 5180 WEST ATLANTIC AVE, DELRAY BEACH, FL, 33484 |
| Name | Role | Address |
|---|---|---|
| SOBLICK DAVID | President | 5180 WEST ATLANTIC, DELRAY BEACH, FL, 33445 |
| Name | Role | Address |
|---|---|---|
| SOBLICK DAVID | Director | 5180 WEST ATLANTIC, DELRAY BEACH, FL, 33445 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
