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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