Provider Demographics
NPI:1023835899
Name:AVID QUALITY CARE LLC
Entity type:Organization
Organization Name:AVID QUALITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-205-7070
Mailing Address - Street 1:1440 FM 2931 STE B
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-5753
Mailing Address - Country:US
Mailing Address - Phone:940-365-9600
Mailing Address - Fax:877-747-2843
Practice Address - Street 1:4800 S HIGHWAY 377 BLDG 800
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-5032
Practice Address - Country:US
Practice Address - Phone:940-365-9600
Practice Address - Fax:877-747-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management