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General NPI Number Information
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NPI Number | 1790276269
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Entity Type | Organization
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Legal Business Name | QUALITY LIFE LAWRENCE, LLC
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 102 GLENN ST
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City | LAWRENCE
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State | MA
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Zip | 01843-1022
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Country | US
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Telephone | 413-206-5880
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Fax | 413-301-7994
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Provider Business Mailing Address
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Address Line | 167 DWIGHT ROAD SUITE #207
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City | LONGMEADOW
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State | MA
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Zip | 01106
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Country | US
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Telephone | 413-206-5880
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Fax | 413-301-7994
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANDREW FELDMAN
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Credential |
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Telephone | 617-584-0258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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