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General NPI Number Information
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NPI Number | 1588994776
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Entity Type | Organization
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Legal Business Name | QUALITY LIFE ASSOCIATES
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 2619 N QUALITY LN SUITE 325
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5589
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Country | US
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Telephone | 479-571-4455
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Fax | 479-571-2288
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Provider Business Mailing Address
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Address Line | 2619 N QUALITY LN SUITE 325
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5589
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Country | US
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Telephone | 479-571-4455
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Fax | 479-571-2288
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Authorized Official
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Title or Position | QUALITY LIFE ASSOCIATES COORDINATOR
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Name | CALEB WESLEY TAYLOR
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Credential |
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Telephone | 479-571-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | AR
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