Provider Demographics
NPI:1811231921
Name:LIFE QUALITY RESOURCES
Entity Type:Organization
Organization Name:LIFE QUALITY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANN-KATRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SJOLUND
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:310-383-4799
Mailing Address - Street 1:15335 MORRISON ST STE 235
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-6707
Mailing Address - Country:US
Mailing Address - Phone:310-383-4799
Mailing Address - Fax:424-227-6714
Practice Address - Street 1:15335 MORRISON ST STE 235
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-6707
Practice Address - Country:US
Practice Address - Phone:310-383-4799
Practice Address - Fax:424-227-6714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-04-1577251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health