Provider Demographics
NPI:1851167357
Name:QOWLOR HOMES. LLC
Entity Type:Organization
Organization Name:QOWLOR HOMES. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:BARTU
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-799-9484
Mailing Address - Street 1:16601 N 75TH AVE UNIT 2084
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-5047
Mailing Address - Country:US
Mailing Address - Phone:480-799-9484
Mailing Address - Fax:
Practice Address - Street 1:744 W MOHAVE STREET
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-8504
Practice Address - Country:US
Practice Address - Phone:480-799-9484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health