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General NPI Number Information
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NPI Number | 1316616626
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Entity Type | Organization
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Legal Business Name | NULIFE HEALTH CARE LLC
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 120 HOLT COLLIER DR STE C
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City | VICKSBURG
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State | MS
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Zip | 39183-4408
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Country | US
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Telephone | 601-738-5565
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Fax | 601-738-5544
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Provider Business Mailing Address
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Address Line | 120 HOLT COLLIER DR STE C
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City | VICKSBURG
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State | MS
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Zip | 39183-4408
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Country | US
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Telephone | 601-738-5565
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Fax | 601-738-5544
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Authorized Official
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Title or Position | MANAGER
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Name | STACY FLOWERS
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Credential |
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Telephone | 601-597-2362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral 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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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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