Provider Demographics
NPI:1457893422
Name:QCC-QUALITY GROUP HOMES, INC.
Entity type:Organization
Organization Name:QCC-QUALITY GROUP HOMES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALTON
Authorized Official - Middle Name:DUKE
Authorized Official - Last Name:DOULPHUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-250-5885
Mailing Address - Street 1:4946 E YALE AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1571
Mailing Address - Country:US
Mailing Address - Phone:559-458-0210
Mailing Address - Fax:
Practice Address - Street 1:4946 E YALE AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1571
Practice Address - Country:US
Practice Address - Phone:559-458-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of Service
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty