Provider Demographics
NPI:1396235115
Name:NU-LIFE T&T SERVICES
Entity type:Organization
Organization Name:NU-LIFE T&T SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEARO
Authorized Official - Middle Name:
Authorized Official - Last Name:ETIENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-412-9775
Mailing Address - Street 1:3404 AVENUE X NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-1053
Mailing Address - Country:US
Mailing Address - Phone:863-412-9775
Mailing Address - Fax:863-582-9918
Practice Address - Street 1:3404 AVENUE X NW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-1053
Practice Address - Country:US
Practice Address - Phone:863-412-9775
Practice Address - Fax:863-582-9918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health