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General NPI Number Information
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NPI Number | 1104719772
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Entity Type | Organization
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Legal Business Name | QOL BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 105 CRIMSON TREE
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City | CIBOLO
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State | TX
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Zip | 78108-4325
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Country | US
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Telephone | 210-980-4767
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Fax | 210-980-4664
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Provider Business Mailing Address
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Address Line | 105 CRIMSON TREE
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City | CIBOLO
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State | TX
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Zip | 78108-4325
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Country | US
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Telephone | 210-980-4767
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Fax | 210-980-4664
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Authorized Official
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Title or Position | MANAGER
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Name | JOSHUA M NOVOTNY
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Credential | APRN
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Telephone | 210-980-4767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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