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General NPI Number Information
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NPI Number | 1841914736
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Entity Type | Organization
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Legal Business Name | NEW LIFE HEALTH AND CONCIERGE LLC
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 1009 PALUXY RD
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City | GRANBURY
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State | TX
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Zip | 76048-2394
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Country | US
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Telephone | 817-910-8049
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Fax | 877-461-4979
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Provider Business Mailing Address
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Address Line | 1030 E US HIGHWAY 377 STE 110 PMB 117
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City | GRANBURY
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State | TX
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Zip | 76048-7849
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Country | US
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Telephone | 817-910-8049
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Fax | 877-461-4979
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Authorized Official
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Title or Position | OWNER/CEO
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Name | CATHERINE C WILSON
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Credential | FNP-BC
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Telephone | 817-910-8049
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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