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General NPI Number Information
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NPI Number | 1245304948
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Entity Type | Organization
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Legal Business Name | QUALITY LIFE SERVICES LLC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 3610 COURTHOUSE RD
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City | CHESTERFIELD
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State | VA
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Zip | 23832-7279
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Country | US
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Telephone | 804-745-5000
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Fax | 888-820-5670
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Provider Business Mailing Address
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Address Line | PO BOX 5684
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-0029
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Country | US
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Telephone | 804-307-0041
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Fax | 888-820-5670
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROBERT SHELTON
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Credential |
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Telephone | 804-307-0041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 88501001
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License Number State | VA
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Taxonomy #2
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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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