| Quality Connections Support Services Llc | |
|
123 Woodlyn Dr Collinsville VA 24078-1660 | |
| (276) 734-3415 | |
| Not Available |
| Full Name | Quality Connections Support Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 123 Woodlyn Dr, Collinsville, Virginia |
| Authorized Official Name and Position | Nacorya Waller (CEO) |
| Authorized Official Contact | 2767343415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quality Connections Support Services Llc 123 Woodlyn Dr Collinsville VA 24078-1660 Ph: (276) 734-3415 | Quality Connections Support Services Llc 123 Woodlyn Dr Collinsville VA 24078-1660 Ph: (276) 734-3415 |
| NPI Number | 1194422881 |
|---|---|
| Provider Enumeration Date | 02/13/2023 |
| Last Update Date | 02/13/2023 |
| Certification Date | 02/13/2023 |
| Medicare PECOS PAC ID | 3779923669 |
|---|---|
| Medicare Enrollment ID | O20240425001222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194422881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Nacorya Waller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831895309 PECOS PAC ID: 9032559927 Enrollment ID: I20240425001367 |
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