Provider Demographics
NPI:1487373593
Name:CLASSIC SUCCESS AFFORDABLE HOMES LLC
Entity type:Organization
Organization Name:CLASSIC SUCCESS AFFORDABLE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWABUNM
Authorized Official - Middle Name:OYINADELIZY
Authorized Official - Last Name:QUADRI-OYENUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-845-2550
Mailing Address - Street 1:1501 S LOOP 288 STE 104
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4708
Mailing Address - Country:US
Mailing Address - Phone:940-484-6245
Mailing Address - Fax:
Practice Address - Street 1:3312 BENTGATE CT
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8613
Practice Address - Country:US
Practice Address - Phone:214-845-2550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health