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General NPI Number Information
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NPI Number | 1043355761
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Entity Type | Organization
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Legal Business Name | QUALITY CARE DEVELOPMENTAL SERVICES INC.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 301 HARREL ST
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City | SALISBURY
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State | NC
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Zip | 28144-5868
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Country | US
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Telephone | 704-645-2397
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Fax | 704-633-5461
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Provider Business Mailing Address
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Address Line | PO BOX 2748
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City | SALISBURY
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State | NC
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Zip | 28145-2748
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Country | US
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Telephone | 704-645-2397
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Fax | 704-633-5461
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Authorized Official
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Title or Position | EXE. DIRECTOR
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Name | MRS. TARA DENISE WHITE
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Credential | B.A. SOCIOLOGY
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Telephone | 704-798-2851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL080-136
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License Number State | NC
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