Healthcare Provider Details

I. General information

NPI: 1023769981
Provider Name (Legal Business Name): QRS FAMILY WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2503 S LINDEN RD STE 190A
FLINT MI
48532-5462
US

IV. Provider business mailing address

2503 S LINDEN RD STE 190A
FLINT MI
48532-5462
US

V. Phone/Fax

Practice location:
  • Phone: 810-370-0409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: QUDONYA SMITH
Title or Position: LCSW
Credential:
Phone: 810-391-6610