Provider Demographics
NPI:1437972858
Name:NU LIFE WELLNESS, LLC
Entity type:Organization
Organization Name:NU LIFE WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TABRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-477-5594
Mailing Address - Street 1:1434 OXBOW DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-4006
Mailing Address - Country:US
Mailing Address - Phone:214-477-5594
Mailing Address - Fax:
Practice Address - Street 1:1434 OXBOW DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-4006
Practice Address - Country:US
Practice Address - Phone:214-477-5594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care