MEDICARE: QUALITY LIVING THROUGH CHOICES LLC

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	302F00000X	Exclusive Provider Organization

General Provider Information

NPI Number	:	1881497758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY LIVING THROUGH CHOICES LLC

Provider Business Mailing Address
First Line	:	3126 SE LOOP 820
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76140-1031
Country	:	US
Telephone Number	:	817-551-3733
Fax Number	:	817-551-3799

Provider Business Practice Location Address
First Line	:	3126 SE LOOP 820
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76140-1031
Country	:	US
Telephone Number	:	817-551-3733
Fax Number	:	817-551-3799

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MICHAEL FORNS
Credential	:
Telephone Number	:	817-551-3733

Provider Enumeration Date	:	03/28/2025
Last Update Date	:	04/02/2025

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Directions to “QUALITY LIVING THROUGH CHOICES LLC ” Practice Location

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