Provider Demographics
NPI:1639468317
Name:QUALITY LIFE IN HOME CARE
Entity Type:Organization
Organization Name:QUALITY LIFE IN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:CHIBUZO
Authorized Official - Last Name:ALILONU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-803-8154
Mailing Address - Street 1:14 N SPRIGG ST
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-5526
Mailing Address - Country:US
Mailing Address - Phone:573-332-1423
Mailing Address - Fax:
Practice Address - Street 1:14 N SPRIGG ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-5526
Practice Address - Country:US
Practice Address - Phone:573-332-1423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LIFE OF JESUS ORGANIZATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO253200000X385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care