MEDICARE: QUALITY ADHC,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285679191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY ADHC,INC.

Provider Business Mailing Address
First Line	:	5350 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-6020
Country	:	US
Telephone Number	:	562-728-4300
Fax Number	:	562-728-4350

Provider Business Practice Location Address
First Line	:	5350 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-6020
Country	:	US
Telephone Number	:	562-728-4300
Fax Number	:	562-728-4350

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LILIA PRYOR
Credential	:
Telephone Number	:	562-728-4300

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/22/2020

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