Healthcare Provider Details

I. General information

NPI: 1447979182
Provider Name (Legal Business Name): QUALITY TIME PROVIDERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 CAPESIDE CIR
WELLINGTON FL
33414-8097
US

IV. Provider business mailing address

1902 CAPESIDE CIR
WEST PALM BEACH FL
33414-8097
US

V. Phone/Fax

Practice location:
  • Phone: 772-301-5720
  • Fax:
Mailing address:
  • Phone: 772-301-5720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: NATASHA WILLIAMSON
Title or Position: OWNER
Credential:
Phone: 772-301-5720