Healthcare Provider Details

I. General information

NPI: 1326438904
Provider Name (Legal Business Name): QUALITY LIVING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 ASHER AVE
LITTLE ROCK AR
72204-6355
US

IV. Provider business mailing address

3925 ASHER AVE
LITTLE ROCK AR
72204-6355
US

V. Phone/Fax

Practice location:
  • Phone: 501-663-3490
  • Fax: 501-663-3446
Mailing address:
  • Phone: 501-663-3490
  • Fax: 501-663-3446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number00206
License Number StateAR

VIII. Authorized Official

Name: CURTIS ANDRA KEITH
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 501-663-3490