Provider Demographics
NPI:1194601088
Name:QUALITY CHOICE SUPPORTED LIVING
Entity type:Organization
Organization Name:QUALITY CHOICE SUPPORTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-307-7917
Mailing Address - Street 1:3712 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1434
Mailing Address - Country:US
Mailing Address - Phone:330-307-7917
Mailing Address - Fax:
Practice Address - Street 1:884 HUNTER ST NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2836
Practice Address - Country:US
Practice Address - Phone:234-223-2945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness