Provider Demographics
NPI:1528232659
Name:QUALITY LIFE CASEMANAGEMENT SERVICES, INC
Entity Type:Organization
Organization Name:QUALITY LIFE CASEMANAGEMENT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:JOHNSON-METHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-466-8930
Mailing Address - Street 1:7027 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2027
Mailing Address - Country:US
Mailing Address - Phone:414-466-8930
Mailing Address - Fax:414-466-2259
Practice Address - Street 1:7027 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2027
Practice Address - Country:US
Practice Address - Phone:414-466-8930
Practice Address - Fax:414-466-2259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management