Provider Demographics
NPI:1790276269
Name:QUALITY LIFE LAWRENCE, LLC
Entity Type:Organization
Organization Name:QUALITY LIFE LAWRENCE, LLC
Other - Org Name:QUALITY LIFE ADULT DAY SERVICES #44
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-584-0258
Mailing Address - Street 1:167 DWIGHT ROAD
Mailing Address - Street 2:SUITE #207
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106
Mailing Address - Country:US
Mailing Address - Phone:413-206-5880
Mailing Address - Fax:413-301-7994
Practice Address - Street 1:102 GLENN ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1022
Practice Address - Country:US
Practice Address - Phone:413-206-5880
Practice Address - Fax:413-301-7994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care