Organization
NULIFE HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY FLOWERS (MANAGER)
(601) 597-2362
Entity
Organization
Contact information
Practice address
120 HOLT COLLIER DR STE C, VICKSBURG, MS 39183-4408
(601) 738-5565
(601) 738-5544
Mailing address
120 HOLT COLLIER DR STE C, VICKSBURG, MS 39183-4408
(601) 738-5565
(601) 738-5544
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
09/09/2021
Last updated
02/25/2022
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