Healthcare Provider Details
I. General information
NPI: 1144388497
Provider Name (Legal Business Name): QUALITY GROUP HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2006
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3990 BRANCH CENTER RD
SACRAMENTO CA
95827-3809
US
IV. Provider business mailing address
4928 E CLINTON WAY SUITE 108
FRESNO CA
93727-1526
US
V. Phone/Fax
- Phone: 916-876-7237
- Fax: 916-875-5586
- Phone: 559-252-6844
- Fax: 559-252-4982
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | 347001429 |
| License Number State | CA |
VIII. Authorized Official
Name: MS.
CARMEN
MARONEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 559-252-6844