Healthcare Provider Details

I. General information

NPI: 1033772207
Provider Name (Legal Business Name): INNER QUALITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 HIGHWAY 171
STONEWALL LA
71078-9403
US

IV. Provider business mailing address

PO BOX 538
STONEWALL LA
71078-0538
US

V. Phone/Fax

Practice location:
  • Phone: 318-906-5054
  • Fax: 318-906-5057
Mailing address:
  • Phone: 318-906-5054
  • Fax: 318-906-5057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: TANESHA WILLIAMS
Title or Position: OWNER/ADMINISTRATOR
Credential: M.ED
Phone: 318-474-8111