Provider Demographics
NPI:1609554823
Name:QUALITY OF LIFE HOSPICE & PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:QUALITY OF LIFE HOSPICE & PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-996-5898
Mailing Address - Street 1:4550 W 103RD ST STE 301D
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4868
Mailing Address - Country:US
Mailing Address - Phone:708-996-5898
Mailing Address - Fax:
Practice Address - Street 1:4550 W 103RD ST STE 301D
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4868
Practice Address - Country:US
Practice Address - Phone:708-996-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based