Provider Demographics
NPI:1104923291
Name:Q.S.A SERVICES INC.
Entity type:Organization
Organization Name:Q.S.A SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DELBRUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:718-328-2605
Mailing Address - Street 1:3501 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-1700
Mailing Address - Country:US
Mailing Address - Phone:718-729-8686
Mailing Address - Fax:718-729-8008
Practice Address - Street 1:3501 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-1700
Practice Address - Country:US
Practice Address - Phone:718-729-8686
Practice Address - Fax:718-729-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090111491324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility