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General NPI Number Information
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NPI Number | 1558256198
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Entity Type | Organization
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Legal Business Name | THE LIVING PLACE LLC
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 11404 GLADEWATER DR
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City | PEARLAND
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State | TX
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Zip | 77584-8246
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Country | US
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Telephone | 908-510-8251
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Fax |
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Provider Business Mailing Address
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Address Line | 11404 GLADEWATER DR
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City | PEARLAND
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State | TX
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Zip | 77584-8246
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | OLUBISI OLULEYE
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Credential |
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Telephone | 908-510-8251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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