MEDICARE: NEW LIFE PERINATAL HEALTH CARE SVCS, INC

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	163W00000X	Registered Nurse	701559	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	095158402	OTHER	TX	HOME HEALTH

General Provider Information

NPI Number	:	1144365594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE PERINATAL HEALTH CARE SVCS, INC

Provider Business Mailing Address
First Line	:	18503 MILL PATH CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5646
Country	:	US
Telephone Number	:	281-578-1205
Fax Number	:	281-578-9305

Provider Business Practice Location Address
First Line	:	18503 MILL PATH CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5646
Country	:	US
Telephone Number	:	281-578-1205
Fax Number	:	281-578-9305

Authorized Official
Title or Position	:	CASE MANAGER
Name	:	MATTIE MARIE MASON
Credential	:	RN, BSN
Telephone Number	:	281-578-1205

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/01/2008

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