Provider Demographics
NPI:1558256198
Name:THE LIVING PLACE LLC
Entity type:Organization
Organization Name:THE LIVING PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLUBISI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLULEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-510-8251
Mailing Address - Street 1:11404 GLADEWATER DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11404 GLADEWATER DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8246
Practice Address - Country:US
Practice Address - Phone:908-510-8251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health