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General NPI Number Information
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NPI Number | 1174629372
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Entity Type | Organization
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Legal Business Name | QUALITY LIFE SERVICES, INC.
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5601 ROANNE WAY SUITE 601
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City | GREENSBORO
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State | NC
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Zip | 27409-3400
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Country | US
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Telephone | 336-852-1464
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Fax |
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Provider Business Mailing Address
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Address Line | 776 BARKER RD
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City | WINSTON SALEM
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State | NC
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Zip | 27107-9045
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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 | PRESIDENT/OWNER
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Name | MR. HENRY L WOOTEN
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Credential |
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Telephone | 336-852-1464
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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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