Provider Demographics
NPI:1609440189
Name:QUALITY OF LIFE HOME HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:QUALITY OF LIFE HOME HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAKEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-435-2874
Mailing Address - Street 1:1851 N VAN PELT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-2113
Mailing Address - Country:US
Mailing Address - Phone:267-239-5582
Mailing Address - Fax:267-239-5582
Practice Address - Street 1:1851 N VAN PELT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-2113
Practice Address - Country:US
Practice Address - Phone:267-239-5582
Practice Address - Fax:267-239-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health