# NULIFE HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316616626
- **Authorized official:** STACY FLOWERS (MANAGER)
- **Authorized official phone:** (601) 597-2362

## Contact information

- **Practice address:** 120 HOLT COLLIER DR STE C, VICKSBURG, MS 39183-4408
- **Practice address phone:** (601) 738-5565
- **Practice address fax:** (601) 738-5544
- **Mailing address:** 120 HOLT COLLIER DR STE C, VICKSBURG, MS 39183-4408
- **Mailing address phone:** (601) 738-5565
- **Mailing address fax:** (601) 738-5544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 09/09/2021
- **Last updated:** 02/25/2022