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Organization
QUALITY OF LIFE OUTPATIENT LLC
Active
Organization
QUALITY OF LIFE OUTPATIENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEUENE KENNEDY HICKMAN III (CHIEF EXECUTIVE OFFICER)
(757) 998-2100
Entity
Organization
Contact information
Practice address
1 ENTERPRISE PKWY STE 315, HAMPTON, VA 23666-5845
(757) 998-2100
(757) 998-2101
Mailing address
1 ENTERPRISE PKWY STE 315, HAMPTON, VA 23666-5845
(757) 998-2100
(757) 998-2101
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/11/2020
Last updated
05/03/2024
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