Quality Of Life Therapy Llc | |
1380 Hines St Se Salem OR 97302-2528 | |
(971) 339-9339 | |
(855) 651-0575 |
Full Name | Quality Of Life Therapy Llc |
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Speciality | Social Worker |
Location | 1380 Hines St Se, Salem, Oregon |
Authorized Official Name and Position | Kimberly Peters (OWNER) |
Authorized Official Contact | 9713389338 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Quality Of Life Therapy Llc Po Box 9274 Salem OR 97305-0274 Ph: (971) 339-9339 | Quality Of Life Therapy Llc 1380 Hines St Se Salem OR 97302-2528 Ph: (971) 339-9339 |
NPI Number | 1861000614 |
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Provider Enumeration Date | 07/17/2020 |
Last Update Date | 07/17/2020 |
Certification Date | 07/17/2020 |
Medicare PECOS PAC ID | 5890110878 |
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Medicare Enrollment ID | O20200807001706 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861000614 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Kimberly Alice Peters |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1265885065 PECOS PAC ID: 6709201783 Enrollment ID: I20200807001745 |
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