Healthcare Provider Details

I. General information

NPI: 1447994009
Provider Name (Legal Business Name): LIFE COORDINATED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 2ND AVE N STE 301
NASHVILLE TN
37201-1010
US

IV. Provider business mailing address

PO BOX 2403
BRENTWOOD TN
37024-2403
US

V. Phone/Fax

Practice location:
  • Phone: 855-209-5451
  • Fax:
Mailing address:
  • Phone: 855-209-5451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. NANCY C EVERITT
Title or Position: PRESIDENT AND CEO
Credential: PMP
Phone: 855-209-5451