Provider Demographics
NPI:1093331225
Name:QUALITY OF LIFE GROUP
Entity Type:Organization
Organization Name:QUALITY OF LIFE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-290-2228
Mailing Address - Street 1:2618 E CORTEZ ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-2906
Mailing Address - Country:US
Mailing Address - Phone:626-290-2228
Mailing Address - Fax:626-339-8856
Practice Address - Street 1:2618 E CORTEZ ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-2906
Practice Address - Country:US
Practice Address - Phone:626-290-2228
Practice Address - Fax:626-339-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty