Organization Active NPI

Quality Life Services, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Greensboro, NC
National Provider Identifier
1174629372
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3409430MedicaidNC

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.