Healthcare Provider Details
I. General information
NPI: 1750332243
Provider Name (Legal Business Name): QUALITY OF LIFE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1409 SPRINGFIELD AVE
GADSDEN AL
35903-2819
US
IV. Provider business mailing address
PO BOX 97
GADSDEN AL
35902-0097
US
V. Phone/Fax
- Phone: 256-492-0131
- Fax:
- Phone: 256-492-0131
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WAYNE
ROWE
Title or Position: CEO
Credential:
Phone: 256-492-0131