Active NPI
Quality Life Services, Inc.
- Developmentally Disabled Services Day Training Agency
- Greensboro, NC
National Provider Identifier
1174629372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- QUALITY LIFE SERVICES, INC.
- Practice address
- 5601 Roanne Way
Suite 601
Greensboro, NC 27409-3400 - Phone
- (336) 852-1464
- NPI assigned
- Sep 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Henry L Wooten
- Title
- President/Owner
- Phone
- (336) 852-1464
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | Primary |
Addresses
Primary practice location
5601 Roanne Way
Suite 601
Greensboro, NC 27409-3400
Mailing address
776 Barker Rd
Winston Salem, NC 27107-9045
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3409430 | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
5601 Roanne Way
Ste 601
Greensboro, NC 27409
Phone (910) 854-5202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1174629372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "776 BARKER RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271079045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 ROANNE WAY",
"address_2": "SUITE 601",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274093400",
"telephone_number": "336-852-1464"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUALITY LIFE SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WOOTEN",
"authorized_official_first_name": "HENRY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "336-852-1464",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3409430",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.