Healthcare Provider Details

I. General information

NPI: 1558800698
Provider Name (Legal Business Name): QLER SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CAMPUS COMMONS DR SUITE 100
RESTON VA
20191-1561
US

IV. Provider business mailing address

1900 CAMPUS COMMONS DRIVE SUITE 100
RESTON VA
20191-1535
US

V. Phone/Fax

Practice location:
  • Phone: 910-523-1052
  • Fax: 800-731-6158
Mailing address:
  • Phone: 910-523-1052
  • Fax: 800-731-6158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: RICK DAVIS
Title or Position: CEO
Credential:
Phone: 312-961-4490