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General NPI Number Information
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NPI Number | 1508643461
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Entity Type | Organization
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Legal Business Name | QUALITY INDEPENDENCE, INC.
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 2826 TAMIAMI TRL STE 2
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5167
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Country | US
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Telephone | 941-457-9171
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Fax |
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Provider Business Mailing Address
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Address Line | 500 W 5TH ST STE 800
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City | WINSTON SALEM
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State | NC
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Zip | 27101-3131
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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
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Name | ANGELA PENNINGTON
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Credential |
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Telephone | 941-457-9171
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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 | 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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