Provider Demographics
NPI:1508886870
Name:NEW LIFE PERINATAL HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:NEW LIFE PERINATAL HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-578-1205
Mailing Address - Street 1:515 N SAM HOUSTON PKWY E STE 215
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4000
Mailing Address - Country:US
Mailing Address - Phone:281-578-1205
Mailing Address - Fax:281-578-9305
Practice Address - Street 1:515 N SAM HOUSTON PKWY E STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4000
Practice Address - Country:US
Practice Address - Phone:281-578-1205
Practice Address - Fax:281-578-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
TX249879251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095158402Medicaid
TX095158404Medicaid