Provider Demographics
NPI:1841914736
Name:NEW LIFE HEALTH AND CONCIERGE LLC
Entity type:Organization
Organization Name:NEW LIFE HEALTH AND CONCIERGE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:817-910-8049
Mailing Address - Street 1:1030 E US HIGHWAY 377 STE 110 PMB 117
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-7849
Mailing Address - Country:US
Mailing Address - Phone:817-910-8049
Mailing Address - Fax:877-461-4979
Practice Address - Street 1:1009 PALUXY RD
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-2394
Practice Address - Country:US
Practice Address - Phone:817-910-8049
Practice Address - Fax:877-461-4979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No251E00000XAgenciesHome Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care