Provider Demographics
NPI:1205422060
Name:QUALITY LIVING TRANSITIONAL HOUSING LLC
Entity type:Organization
Organization Name:QUALITY LIVING TRANSITIONAL HOUSING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-222-5737
Mailing Address - Street 1:2333 BONNYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75134-2824
Mailing Address - Country:US
Mailing Address - Phone:469-222-5737
Mailing Address - Fax:972-748-2329
Practice Address - Street 1:119 EXECUTIVE WAY STE 301
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2341
Practice Address - Country:US
Practice Address - Phone:214-792-9134
Practice Address - Fax:972-748-2329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health