Provider Demographics
NPI:1811290950
Name:LIFE NURTURING HEALTH AGENCY
Entity type:Organization
Organization Name:LIFE NURTURING HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/DIRECTOR OF NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHEY
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:SESE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:817-545-9171
Mailing Address - Street 1:1021 TEXAS STAR CT
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040
Mailing Address - Country:US
Mailing Address - Phone:817-545-9171
Mailing Address - Fax:
Practice Address - Street 1:1021 TEXAS STAR CT
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040
Practice Address - Country:US
Practice Address - Phone:817-545-9171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXA210004746163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty