Provider Demographics
NPI:1053015867
Name:QUALITY SUPPORT SERVICES, L.L.C.
Entity type:Organization
Organization Name:QUALITY SUPPORT SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SIONE
Authorized Official - Middle Name:UEIKAETAU
Authorized Official - Last Name:TAKAPU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-465-7296
Mailing Address - Street 1:5561 W ELAINE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-4406
Mailing Address - Country:US
Mailing Address - Phone:310-465-7296
Mailing Address - Fax:
Practice Address - Street 1:5561 W ELAINE AVE
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84120-4406
Practice Address - Country:US
Practice Address - Phone:310-465-7296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency