Healthcare Provider Details

I. General information

NPI: 1477491686
Provider Name (Legal Business Name): QUALITY LIFE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11490 COMMERCE PARK DR STE 522
RESTON VA
20191-1574
US

IV. Provider business mailing address

11490 COMMERCE PARK DR STE 522
RESTON VA
20191-1574
US

V. Phone/Fax

Practice location:
  • Phone: 571-250-9508
  • Fax:
Mailing address:
  • Phone: 571-250-9508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NORMA R MALTEZ
Title or Position: OWNER
Credential:
Phone: 571-250-9508