MEDICARE: TIME IN FUTURE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1093597106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIME IN FUTURE, LLC

Provider Business Mailing Address
First Line	:	2911 EL DORADO BLVD APT 9304
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5758
Country	:	US
Telephone Number	:	281-636-9209
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 EL DORADO BLVD
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5737
Country	:	US
Telephone Number	:	281-636-9209
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	JEANETTE TIFRE
Credential	:	RN
Telephone Number	:	281-636-9209

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	12/05/2023

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