MEDICARE: RIGHTEOUS LIVITY WORKS 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1194540021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIGHTEOUS LIVITY WORKS LLC

Provider Business Mailing Address
First Line	:	6500 GREENVILLE AVE STE 430
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1014
Country	:	US
Telephone Number	:	214-838-6469
Fax Number	:

Provider Business Practice Location Address
First Line	:	6500 GREENVILLE AVE STE 430
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1014
Country	:	US
Telephone Number	:	214-838-6469
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MISS NINA S. FAKUNLE
Credential	:	FNP-C
Telephone Number	:	469-931-3960

Provider Enumeration Date	:	11/15/2024
Last Update Date	:	02/02/2026

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Directions to “RIGHTEOUS LIVITY WORKS LLC ” Practice Location

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