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General NPI Number Information
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NPI Number | 1548055288
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Entity Type | Organization
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Legal Business Name | QUALITY OF LIFE LLC
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Dates
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Enumeration Date | 04/12/2025
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Last Update Date | 04/12/2025
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Provider Practice Location Address
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Address Line | 2925 ROWAN ST
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City | LOUISVILLE
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State | KY
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Zip | 40212-1855
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Country | US
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Telephone | 502-219-2566
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 ROWAN ST
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City | LOUISVILLE
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State | KY
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Zip | 40212-1855
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Country | US
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Telephone | 502-219-2566
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Fax |
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Authorized Official
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Title or Position | OWNER/CO-FOUNDER/MANAGER
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Name | KELLY LYNN SAMUELS
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Credential | CRSS
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Telephone | 502-219-2566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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