Provider Demographics
NPI:1073368932
Name:QLAY WELLNESS
Entity type:Organization
Organization Name:QLAY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-633-5055
Mailing Address - Street 1:51398 TIDES DR BLDG 2
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-2354
Mailing Address - Country:US
Mailing Address - Phone:313-633-5055
Mailing Address - Fax:
Practice Address - Street 1:51398 TIDES DR BLDG 2
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-2354
Practice Address - Country:US
Practice Address - Phone:313-633-5055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health