Organization
QUALITY CHOICE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA L BAGNOLA (CEO)
(330) 371-1855
Entity
Organization
Contact information
Practice address
3074 RUSTY AVE SW, CANTON, OH 44706-3329
(330) 371-1855
(330) 478-3262
Mailing address
3074 RUSTY AVE SW, CANTON, OH 44706-3329
(330) 371-1855
(330) 478-3262
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7604579
MBS CONTRACT NUMBER
OH
Enumeration date
05/03/2008
Last updated
05/29/2008
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