NPIMap

Organization Active NPI

Quality of Life Health Services, Inc

Doing business as Cleburne Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Heflin, AL
National Provider Identifier
1467620989
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
QUALITY OF LIFE HEALTH SERVICES, INC
Doing business as
Cleburne Quality Health Care
Practice address
64 Giles St
Heflin, AL 36264-1738
Phone
(256) 463-2021
NPI assigned
Feb 19, 2008
Last updated
Mar 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wayne Rowe, MPA
Title
Ceo
Phone
(256) 492-0131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

64 Giles St
Heflin, AL 36264-1738

Mailing address

PO Box 97
Gadsden, AL 35902-0097
Phone (256) 492-0131

Other identifiers 2

IdentifierTypeStateIssuer
E-948OtherALMEDICARE PART B PTAN
100370MedicaidAL

Other names 1

  • CLEBURNE QUALITY HEALTH CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040324000006 AL Part B Supplier - Clinic/Group Practice 7810890902 Receives reassigned benefits from 125 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Heflin, AL; Horton, AL; Lafayette, AL; Lanett, AL; Oneonta, AL; Phenix City, AL; Sardis City, AL; Talladega, AL…
O20080229000546 AL Part A Provider - Federally Qualified Health Center (FQHC) 7810890902 Practice locations: Heflin, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467620989. Details of each certification follow.

Federally qualified health center certification: CCN 011949

Legal name
QUALITY OF LIFE HEALTH SERVICES INC
Doing business as
CLEBURNE QUALITY HEALTH CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 26, 2008
Last certification
Mar 26, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 1977 in AL
Enrollment address
64 Giles St
Heflin, AL 36264-1738

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1079468Cleburne Quality Health Care64 Giles Street, Heflin, AL 36264Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Quality of Life Health30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1316 Noble St
Anniston, AL 36201
Phone (256) 236-0221

4055 AL Highway 9
Cedar Bluff, AL 35959
Phone (256) 779-6057

3330 Cedar Bluff Rd
Centre, AL 35960
Phone (256) 779-6057

1117 Tuscaloosa Ave
Gadsden, AL 35901
Phone (256) 546-4606

1216 Wilbanks Ave
Gadsden, AL 35903
Phone (256) 439-6384

927 Raley St
Gadsden, AL 35903
Phone (256) 439-6384

12062 AL Highway 227
Geraldine, AL 35974
Phone (256) 659-2422

242 Brockford Rd
Heflin, AL 36264
Phone (256) 463-2021

1502 11th Ave
Phenix City, AL 36867
Phone (334) 560-5393

110 Spring St N
Talladega, AL 35160
Phone (256) 315-1697

1201 Notasulga Rd
Tuskegee, AL 36083
Phone (334) 727-7211

707 W Martin Luther King Hwy
Tuskegee, AL 36083
Phone (334) 727-7211

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Wayne C Rowe Individual Corporate DirectorCeo Feb 4, 2008 100%
W-2 Managing EmployeeCeo Feb 4, 2008 100%
Jean M Ward Individual Corporate DirectorBoard Treasurer Nov 30, 1989
Christopher a Reynolds Individual Corporate DirectorBoard Member Jul 18, 2013
Kristie L Cornelious Individual Corporate DirectorBoard Member Jan 19, 2017
Muhammad Kamran Individual Corporate DirectorBoard Treasurer Nov 21, 2019
Tarva N Vaughn Individual Corporate DirectorBoard Vice President Jan 9, 1996
Carolyn H Parker Individual Corporate DirectorBoard Member Jun 14, 2012
Johnjalene E Woods Individual Corporate DirectorBoard Member Sep 21, 2017
Dante a Whittaker Individual Corporate DirectorBoard Member Feb 17, 2005
Patricia Deramus Individual Corporate DirectorBoard Secretary Apr 16, 2009
Jodi D Leighton Individual Corporate DirectorBoard Member Dec 15, 2016
Duane a Reddick Individual Corporate DirectorBoard Member Sep 21, 2017
Cecilia Cruz-Zanzig Individual Corporate DirectorBoard Member Jun 26, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Blount County Quality Health CareOneonta, AL, CCN 011947 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 19, 2008
Douglas Medical CenterHorton, AL, CCN 011957 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 10, 2009
Dec 10, 2009
Dekalb Quality Health CareGeraldine, AL, CCN 011962 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 1, 2011
Sep 1, 2011
Wadley Cornerstone ClinicWadley, AL, CCN 011963 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 21, 2009
Dec 21, 2009
Procare Colley HomesGadsden, AL, CCN 011874 Federally qualified health center 5% Or Greater Direct Ownership Interest Jun 16, 1994
Calhoun Quality Health CareAnniston, AL, CCN 011010 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 10, 2014
Susie E Allen Health CenterPhenix City, AL, CCN 011025 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 23, 2015
Dec 23, 2015
Chambers Quality Health CareLanett, AL, CCN 011036 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control (100%)		 Jul 14, 2017
Jul 14, 2017

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 139

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 139

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1467620989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359020097",
            "telephone_number": "256-492-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 GILES ST",
            "city": "HEFLIN",
            "state": "AL",
            "postal_code": "362641738",
            "telephone_number": "256-463-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY OF LIFE HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "ROWE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-492-0131",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B PTAN",
            "identifier": "E-948",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100370",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLEBURNE QUALITY HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heflin, AL

Sources for this page

Verify at the official NPI Registry.