Provider Demographics
NPI:1235306309
Name:QUALITY LIFESTYLE INC.
Entity Type:Organization
Organization Name:QUALITY LIFESTYLE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ALTERMEASE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-594-0899
Mailing Address - Street 1:5104 N ORANGE BLOSSOM TRL
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1042
Mailing Address - Country:US
Mailing Address - Phone:321-594-0899
Mailing Address - Fax:
Practice Address - Street 1:5104 N ORANGE BLOSSOM TRL
Practice Address - Street 2:SUITE 110
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1042
Practice Address - Country:US
Practice Address - Phone:321-594-0899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL681321462251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL685646296Medicaid