MEDICARE: TREVON LIVINGSTON QBHS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1326916040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVON LIVINGSTON QBHS

Provider Business Mailing Address
First Line	:	73 ROSEWOOD DR
Second Line	:
City	:	AVON LAKE
State	:	OH
Zip	:	44012-1307
Country	:	US
Telephone Number	:	440-752-7810
Fax Number	:	216-516-0483

Provider Business Practice Location Address
First Line	:	11201 SHAKER BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3869
Country	:	US
Telephone Number	:	440-752-7810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2025
Last Update Date	:	02/09/2026

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