Provider Demographics
NPI:1831843119
Name:QUALITY LIFE BLUEPRINT
Entity type:Organization
Organization Name:QUALITY LIFE BLUEPRINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDUL HAFEEDH
Authorized Official - Middle Name:MUHAMMAD
Authorized Official - Last Name:BIN ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-373-2947
Mailing Address - Street 1:1219 DAWSON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-5911
Mailing Address - Country:US
Mailing Address - Phone:971-373-2947
Mailing Address - Fax:
Practice Address - Street 1:1219 DAWSON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-5911
Practice Address - Country:US
Practice Address - Phone:971-373-2947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare