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General NPI Number Information
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NPI Number | 1154998441
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Entity Type | Organization
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Legal Business Name | ENHANCING THE QUALITY OF LIFE LLC
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 1036 BRANCHVIEW DR STE 104
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City | CONCORD
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State | NC
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Zip | 28025-0112
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Country | US
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Telephone | 980-248-1900
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Fax | 855-552-0225
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Provider Business Mailing Address
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Address Line | 1036 BRANCHVIEW DR STE 104
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City | CONCORD
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State | NC
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Zip | 28025-0112
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Country | US
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Telephone | 980-248-1900
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. CAROL DENISE GUNTER
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Credential |
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Telephone | 704-699-9297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 251T00000X
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Taxonomy Name | PACE Provider Organization
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care 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 | 385HR2050X
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Taxonomy Name | Respite Care Camp
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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 | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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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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