Provider Demographics
NPI:1023574183
Name:QUALITY LIVES ASSISTED LIVING /ADULT DAY LLC
Entity Type:Organization
Organization Name:QUALITY LIVES ASSISTED LIVING /ADULT DAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GYTON
Authorized Official - Middle Name:BRIJJETTA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-822-5784
Mailing Address - Street 1:226 PAULINE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-7012
Mailing Address - Country:US
Mailing Address - Phone:662-822-5784
Mailing Address - Fax:662-702-5178
Practice Address - Street 1:226 PAULINE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-7012
Practice Address - Country:US
Practice Address - Phone:662-822-5784
Practice Address - Fax:662-702-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care