Provider Demographics
NPI:1952022568
Name:QUALITY LIFESTYLE SERVICE, INC.
Entity Type:Organization
Organization Name:QUALITY LIFESTYLE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-635-0752
Mailing Address - Street 1:113 N MOORE ROAD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3919
Mailing Address - Country:US
Mailing Address - Phone:423-698-1061
Mailing Address - Fax:423-521-8950
Practice Address - Street 1:113 N MOORE ROAD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-3919
Practice Address - Country:US
Practice Address - Phone:423-698-1061
Practice Address - Fax:423-521-8950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home