# C & R QUALITY LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649595513
- **Authorized official:** MR. ROOSEVELT GAYLAH (PRESIDENT)
- **Authorized official phone:** (701) 235-5744

## Contact information

- **Practice address:** 1336 25TH AVE S STE 213, FARGO, ND 58103-5202
- **Practice address phone:** (701) 235-5744
- **Practice address fax:** (701) 235-5569
- **Mailing address:** 1336 25TH AVE S STE 213, FARGO, ND 58103-5202
- **Mailing address phone:** (701) 235-5744
- **Mailing address fax:** (701) 235-5569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 10067100 | ND | Yes |

## Other

- **Enumeration date:** 04/02/2010
- **Last updated:** 04/02/2010