Provider Demographics
NPI:1831568237
Name:QUALITY OF LIFE HEALTH SERVICES, INC
Entity type:Organization
Organization Name:QUALITY OF LIFE HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:256-492-0131
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902-0097
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1502 11TH AVE
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-4905
Practice Address - Country:US
Practice Address - Phone:334-560-5393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)