Provider Demographics
NPI:1124863501
Name:FOREST, QUINTIN R (QBHS)
Entity type:Individual
Prefix:MR
First Name:QUINTIN
Middle Name:R
Last Name:FOREST
Suffix:
Gender:M
Credentials:QBHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-5105
Mailing Address - Country:US
Mailing Address - Phone:938-688-9232
Mailing Address - Fax:
Practice Address - Street 1:317 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-5105
Practice Address - Country:US
Practice Address - Phone:938-688-9232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator