Provider Demographics
NPI:1720499502
Name:QUALITY LIFE CENTER LLC
Entity Type:Organization
Organization Name:QUALITY LIFE CENTER LLC
Other - Org Name:TENNESSEE VALLEY DRUG TESTING MGMT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:MCCULLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-826-2913
Mailing Address - Street 1:204 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5532
Mailing Address - Country:US
Mailing Address - Phone:256-826-2913
Mailing Address - Fax:256-826-2913
Practice Address - Street 1:1810 JOHN R ST
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661
Practice Address - Country:US
Practice Address - Phone:256-826-2913
Practice Address - Fax:256-826-2913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty