NPIMap

Organization Active NPI

Quality of Life Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Phenix City, AL
National Provider Identifier
1831568237
Registry record updated Jan 27, 2017
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
Practice address
1502 11TH Ave
Phenix City, AL 36867-4905
Phone
(334) 560-5393
NPI assigned
Sep 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

1502 11TH Ave
Phenix City, AL 36867-4905

Mailing address

PO Box 97
Gadsden, AL 35902-0097

Other names 1

  • SUSIE E. ALLEN HEALTH CENTER 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…
O20151208003021 AL Part A Provider - Federally Qualified Health Center (FQHC) 7810890902 Practice locations: Phenix City, AL

Federally qualified health center certification: CCN 011025

Legal name
QUALITY OF LIFE HEALTH SERVICES INC
Doing business as
SUSIE E ALLEN HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 23, 2015
Last certification
Dec 23, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 1977 in AL
Enrollment address
1502 11TH Ave
Phenix City, AL 36867-4905

All disclosed owners & managing parties 18

Medicare enrollment files

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

NameRoleSinceShare
Tia N Freeman Individual Corporate DirectorBoard Member Nov 1, 2016
Wayne C Rowe Individual Corporate DirectorPresident/Ceo Dec 23, 2015 100%
W-2 Managing EmployeePresident/Ceo Dec 23, 2015 100%
Mario a Saenz Individual Corporate DirectorBoard Member Jul 15, 2010
Urick Wright Individual Corporate DirectorBoard Member Aug 20, 2020
Jean M Ward Individual Corporate DirectorBoard Treasurer Nov 30, 1989
Bobby M Junkins Individual Corporate DirectorBoard Member Aug 21, 1989
Tonia Rosser Individual Corporate DirectorBoard Member Jul 16, 2020
Christopher a Reynolds Individual Corporate DirectorBoard Member Jun 24, 2022
Kristie L Cornelious Individual Corporate DirectorBoard Member Jan 19, 2017
Linda Wade Individual Corporate DirectorBoard Member Mar 17, 2022
Muhammad Kamran Individual Corporate DirectorBoard Member Nov 21, 2019
Tina M Cylar Individual Corporate DirectorBoard Member Feb 26, 2004
Quality of Life Health Services Inc Organization, Gadsden, AL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 23, 2015 100%
Operational/Managerial Control Dec 23, 2015 100%
Dante a Whittaker Individual Corporate DirectorBoard Member Jun 24, 2022
Veronica Rawls Individual Corporate DirectorBoard Member Jun 24, 2022
Emily McClain Individual Corporate DirectorBoard Member May 19, 2022
Duane a Reddick Individual Corporate DirectorBoard Treasurer Jun 24, 2022
Cecilia Cruz-Zanzig Individual Corporate DirectorBoard Member Jun 24, 2022

All facility ownership & control disclosures 7

Medicare enrollment files

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
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

National Provider Directory

National Provider Directory
Tax ID family
R O Watts Clinic30 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

Owners & managing parties with NPI records 23

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

View all 23

Owned or controlled facilities with NPI records 7

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

Other NPIs on the same Medicare enrollment 22

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

View all 22

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

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 48

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
01D2099747Susie E Allen Health Center1502 11TH Avenue, Phenix City, AL 36867Certificate of waiverJul 30, 2027

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1831568237",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 11TH AVE",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368674905",
            "telephone_number": "334-560-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY OF LIFE HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "ROWE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "C",
        "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": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUSIE E. ALLEN HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phenix City, AL

Sources for this page

Verify at the official NPI Registry.