Healthcare Provider Details

I. General information

NPI: 1932110384
Provider Name (Legal Business Name): QUALITY LIFE HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 EAST ST LOWER LEVEL
PITTSBORO NC
27312
US

IV. Provider business mailing address

PO BOX 1892
PITTSBORO NC
27312-1892
US

V. Phone/Fax

Practice location:
  • Phone: 919-545-2027
  • Fax: 919-545-2029
Mailing address:
  • Phone: 919-545-2027
  • Fax: 919-545-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3369
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARBARA BELTON JOHNSON
Title or Position: OWNER/ADMINISTRATOR
Credential: REGISTERED NURSE
Phone: 919-545-2027