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General NPI Number Information
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NPI Number | 1063530418
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Entity Type | Organization
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Legal Business Name | QUALITY FAMILY SERVICES, INC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 369 PENNTON AVE SW
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City | LENOIR
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State | NC
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Zip | 28645-4644
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Country | US
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Telephone | 828-754-6998
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Fax |
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Provider Business Mailing Address
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Address Line | 8520 MORGAN MILL RD
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City | MONROE
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State | NC
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Zip | 28110-9052
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | CHRISTOPHER GOULD
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Credential |
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Telephone | 828-754-6998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 17042
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License Number State | NC
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