Provider Demographics
NPI:1801510243
Name:KPS QUALITY OF LIFE SERVICES
Entity type:Organization
Organization Name:KPS QUALITY OF LIFE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AYANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-290-4605
Mailing Address - Street 1:3550 EXECUTIVE PKWY STE 7-118
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1379
Mailing Address - Country:US
Mailing Address - Phone:419-407-5077
Mailing Address - Fax:
Practice Address - Street 1:3550 EXECUTIVE PKWY STE 7-118
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1379
Practice Address - Country:US
Practice Address - Phone:419-407-5077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty