Provider Demographics
NPI:1679094320
Name:QUALITY REHABILITATION SERVICES LLC
Entity type:Organization
Organization Name:QUALITY REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-348-7324
Mailing Address - Street 1:355 W MARTIN LUTHER KING BLVD APT 1117
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-0043
Mailing Address - Country:US
Mailing Address - Phone:980-348-7324
Mailing Address - Fax:
Practice Address - Street 1:1900 BLANDING DR
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-5931
Practice Address - Country:US
Practice Address - Phone:980-348-7324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health