Provider Demographics
NPI:1205140092
Name:QUALITY LIFE SERVICES LLC
Entity type:Organization
Organization Name:QUALITY LIFE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-317-8722
Mailing Address - Street 1:1251 NILLES RD STE 3
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7205
Mailing Address - Country:US
Mailing Address - Phone:513-860-1481
Mailing Address - Fax:513-297-9424
Practice Address - Street 1:1251 NILLES RD STE 3
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7205
Practice Address - Country:US
Practice Address - Phone:513-860-1481
Practice Address - Fax:513-297-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH369023Medicare Oscar/Certification