Healthcare Provider Details

I. General information

NPI: 1740230945
Provider Name (Legal Business Name): QUALITY OF LIFE HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SPRING ST N
TALLADEGA AL
35160-2040
US

IV. Provider business mailing address

PO BOX 97
GADSDEN AL
35902-0097
US

V. Phone/Fax

Practice location:
  • Phone: 256-492-0131
  • Fax:
Mailing address:
  • Phone: 256-492-0131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WAYNE ROWE
Title or Position: CEO
Credential:
Phone: 256-492-0131