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General NPI Number Information
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NPI Number | 1295815108
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Entity Type | Organization
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Legal Business Name | S R QUALITY ASSISTED LIVING INC.
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1543 W 80TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90047-2843
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Country | US
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Telephone | 323-867-8929
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Fax |
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Provider Business Mailing Address
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Address Line | 1543 W 80TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90047-2843
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Country | US
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Telephone | 323-867-8929
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. RHONDA GALE WASHINGTON-JAMES
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Credential |
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Telephone | 323-867-8929
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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 | 2771224
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License Number State | CA
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