Provider Demographics
NPI:1790017119
Name:TEXAS QUALITY LIVING INC.
Entity type:Organization
Organization Name:TEXAS QUALITY LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:N
Authorized Official - Last Name:EZENNIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-429-6644
Mailing Address - Street 1:3214 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-2365
Mailing Address - Country:US
Mailing Address - Phone:972-898-4483
Mailing Address - Fax:972-782-9922
Practice Address - Street 1:3214 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-2365
Practice Address - Country:US
Practice Address - Phone:972-898-4483
Practice Address - Fax:972-782-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care