Provider Demographics
NPI:1568619609
Name:QUALITY LIFE PROVIDERS, LLC
Entity Type:Organization
Organization Name:QUALITY LIFE PROVIDERS, LLC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MRUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:614-527-9999
Mailing Address - Street 1:4115 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1476
Mailing Address - Country:US
Mailing Address - Phone:614-527-9999
Mailing Address - Fax:614-529-0776
Practice Address - Street 1:4115 MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1476
Practice Address - Country:US
Practice Address - Phone:614-527-9999
Practice Address - Fax:614-529-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty