Provider Demographics
NPI:1578211413
Name:SPIRIT OF LIFE NURSE SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:SPIRIT OF LIFE NURSE SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MAXIE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-291-0366
Mailing Address - Street 1:13331 VETERANS MEMORIAL DR STE G
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1610
Mailing Address - Country:US
Mailing Address - Phone:346-291-0366
Mailing Address - Fax:346-273-2168
Practice Address - Street 1:13331 VETERANS MEMORIAL DR STE G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1610
Practice Address - Country:US
Practice Address - Phone:346-291-0366
Practice Address - Fax:346-273-2168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare