Provider Demographics
NPI:1033772207
Name:INNER QUALITY SERVICES
Entity Type:Organization
Organization Name:INNER QUALITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TANESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:318-474-8111
Mailing Address - Street 1:PO BOX 538
Mailing Address - Street 2:
Mailing Address - City:STONEWALL
Mailing Address - State:LA
Mailing Address - Zip Code:71078-0538
Mailing Address - Country:US
Mailing Address - Phone:318-906-5054
Mailing Address - Fax:318-906-5057
Practice Address - Street 1:1318 HIGHWAY 171
Practice Address - Street 2:
Practice Address - City:STONEWALL
Practice Address - State:LA
Practice Address - Zip Code:71078-9403
Practice Address - Country:US
Practice Address - Phone:318-906-5054
Practice Address - Fax:318-906-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child