Healthcare Provider Details

I. General information

NPI: 1669316105
Provider Name (Legal Business Name): QSWP GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 HARMON DR
VALDOSTA GA
31601-3571
US

IV. Provider business mailing address

1505 HARMON DR
VALDOSTA GA
31601-3571
US

V. Phone/Fax

Practice location:
  • Phone: 229-541-6286
  • Fax: 229-541-6286
Mailing address:
  • Phone: 229-541-6286
  • Fax: 229-541-6286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE PAUL
Title or Position: OWNER/CEO
Credential:
Phone: 229-541-6286