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General NPI Number Information
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NPI Number | 1225795529
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Entity Type | Organization
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Legal Business Name | NULIFE HEALTH SERVICES
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Dates
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Enumeration Date | 11/21/2021
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Last Update Date | 11/21/2021
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Provider Practice Location Address
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Address Line | 1202 CATALPA DR
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City | ROYAL OAK
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State | MI
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Zip | 48067-1127
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Country | US
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Telephone | 313-279-0053
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Fax |
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Provider Business Mailing Address
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Address Line | 1252 IDA WOODS LN
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-9117
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Country | US
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Telephone | 248-894-8905
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMBERLY SULLIVAN
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Credential |
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Telephone | 248-894-8905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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