Provider Demographics
NPI:1013627942
Name:LIFE'S PATH FORWARD LLC
Entity Type:Organization
Organization Name:LIFE'S PATH FORWARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KANDZ
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:DAIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-316-8566
Mailing Address - Street 1:PO BOX 331048
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77233-1048
Mailing Address - Country:US
Mailing Address - Phone:832-316-8566
Mailing Address - Fax:
Practice Address - Street 1:4910 LINCOLNSHIRE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77048-4723
Practice Address - Country:US
Practice Address - Phone:832-316-8566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging
No174200000XOther Service ProvidersMeals
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
NB4842LP4WDOtherSERVICES PROVIDER