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General NPI Number Information
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NPI Number | 1295023224
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Entity Type | Organization
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Legal Business Name | REAL LIFE SERVICES (RLS)
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 724 HWY 36 BYP N
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City | GATESVILLE
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State | TX
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Zip | 76528-9603
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Country | US
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Telephone | 254-865-8828
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Fax | 254-865-8828
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Provider Business Mailing Address
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Address Line | 724 HWY 36 BYP N
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City | GATESVILLE
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State | TX
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Zip | 76528-9603
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Country | US
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Telephone | 254-865-8828
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Fax | 254-865-8828
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. IRENE BURTON MAGEE-SALCIDO
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Credential | RN,BC
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Telephone | 254-913-1637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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