QUALITY LIFE HCS, LLC

Provider Demographics

• NPI: 1083843528
• Name: QUALITY LIFE HCS, LLC
• Entity Type: Organization
• Organization Name: QUALITY LIFE HCS, LLC
• Authorized Official - Title/Position: OWNER/PRESIDENT
• Authorized Official - Prefix: DR
• Authorized Official - First Name: LEO
• Authorized Official - Middle Name: J
• Authorized Official - Last Name: BORRELL
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 713-850-0049
• Mailing Address - Street 1: 4314 YOAKUM BLVD
• Mailing Address - City: HOUSTON
• Mailing Address - State: TX
• Mailing Address - Zip Code: 77006-5818
• Mailing Address - Country: US
• Mailing Address - Phone: 713-850-0049
• Mailing Address - Fax: 713-850-0036
• Practice Address - Street 1: 4314 YOAKUM BLVD
• Practice Address - City: HOUSTON
• Practice Address - State: TX
• Practice Address - Zip Code: 77006-5818
• Practice Address - Country: US
• Practice Address - Phone: 713-850-0049
• Practice Address - Fax: 713-850-0036
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2009-07-06
• Last Update Date: 2012-05-10

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	320900000X	Residential Treatment Facilities	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Group - Multi-Specialty
No	101Y00000X	Behavioral Health & Social Service Providers	Counselor		Group - Multi-Specialty
No	101YP2500X	Behavioral Health & Social Service Providers	Counselor	Professional	Group - Multi-Specialty
No	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Multi-Specialty
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	103TM1800X	Behavioral Health & Social Service Providers	Psychologist	Intellectual & Developmental Disabilities	Group - Multi-Specialty
No	104100000X	Behavioral Health & Social Service Providers	Social Worker		Group - Multi-Specialty
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Multi-Specialty
No	2084N0400X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Neurology	Group - Multi-Specialty
No	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family	Group - Multi-Specialty
No	363LP0808X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Psychiatric/Mental Health	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
TX	287815901	Medicaid
TX	TXB142762	Medicare PIN