Provider Demographics
NPI:1144756891
Name:QUALITY OF LIFE
Entity Type:Organization
Organization Name:QUALITY OF LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-718-2328
Mailing Address - Street 1:22130 RHEA CO HWY
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37381
Mailing Address - Country:US
Mailing Address - Phone:423-718-2328
Mailing Address - Fax:423-365-0761
Practice Address - Street 1:22130 RHEA COUNTY HWY
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:TN
Practice Address - Zip Code:37381-5243
Practice Address - Country:US
Practice Address - Phone:423-718-2328
Practice Address - Fax:423-365-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN159069251C00000X, 251J00000X
253Z00000X
TNLPN0000052001305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No305R00000XManaged Care OrganizationsPreferred Provider Organization