MEDICARE: LIFE WAVE HOSPICE CARE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1538809017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE WAVE HOSPICE CARE LLC

Provider Business Mailing Address
First Line	:	2646 S LOOP W STE 635B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:	713-667-7202
Fax Number	:

Provider Business Practice Location Address
First Line	:	2646 S LOOP W STE 635B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:	713-667-7202
Fax Number	:

Authorized Official
Title or Position	:	CEO / ADMINISTRATOR
Name	:	KUDY ADELAKUN
Credential	:	FNP-C
Telephone Number	:	713-667-7202

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	05/07/2026

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Directions to “LIFE WAVE HOSPICE CARE LLC ” Practice Location

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