Provider Demographics
NPI:1043419971
Name:QUALITY QUEST
Entity Type:Organization
Organization Name:QUALITY QUEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-416-3100
Mailing Address - Street 1:PO BOX 232501
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-0425
Mailing Address - Country:US
Mailing Address - Phone:916-416-3100
Mailing Address - Fax:
Practice Address - Street 1:96 TRISTAN CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4145
Practice Address - Country:US
Practice Address - Phone:916-416-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALTC60808G320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8302932Medicaid