Healthcare Provider Details

I. General information

NPI: 1497928683
Provider Name (Legal Business Name): QMH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 E CAPITOL ST
JACKSON MS
39201-2503
US

IV. Provider business mailing address

7431 114TH AVE SUITE 104
LARGO FL
33773-5119
US

V. Phone/Fax

Practice location:
  • Phone: 800-632-6074
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name: KEVIN D HARWOOD
Title or Position: PRESIDENT/CEO
Credential:
Phone: 800-632-6074