Provider Demographics
NPI: | 1750436663 |
---|---|
Name: | QUALITY CARE & ADVOCACY GROUP, INC. |
Entity type: | Organization |
Organization Name: | QUALITY CARE & ADVOCACY GROUP, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SANDRA |
Authorized Official - Middle Name: | CAMPBELL |
Authorized Official - Last Name: | TAYLOR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 910-476-2941 |
Mailing Address - Street 1: | 863 FLAT SHOALS RD SE # C181 |
Mailing Address - Street 2: | |
Mailing Address - City: | CONYERS |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30094-6633 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 910-476-2941 |
Mailing Address - Fax: | 910-483-5331 |
Practice Address - Street 1: | 4286 MEMORIAL DR STE A |
Practice Address - Street 2: | |
Practice Address - City: | DECATUR |
Practice Address - State: | GA |
Practice Address - Zip Code: | 30032-1221 |
Practice Address - Country: | US |
Practice Address - Phone: | 910-476-2941 |
Practice Address - Fax: | 404-600-4878 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-01-24 |
Last Update Date: | 2015-08-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |