NPIMap

Organization Active NPI

Nulife Health Care LLC

  • Clinic/Center
  • Vicksburg, MS
National Provider Identifier
1316616626
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NULIFE HEALTH CARE LLC
Practice address
120 Holt Collier Dr Ste C
Vicksburg, MS 39183-4408
Phone
(601) 738-5565
Fax
(601) 738-5544
NPI assigned
Sep 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stacy FlowersNPI 1629272596
Title
Manager
Phone
(601) 597-2362

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X
Clinic/Center 261Q00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Respite Care 385H00000X

Addresses

Primary practice location

120 Holt Collier Dr Ste C
Vicksburg, MS 39183-4408

Mailing address

120 Holt Collier Dr Ste C
Vicksburg, MS 39183-4408
Phone (601) 738-5565

National Provider Directory

National Provider Directory

Locations

120 Holt Collier Dr
Ste C
Vicksburg, MS 39183
Phone (601) 597-2362

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1316616626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HOLT COLLIER DR STE C",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391834408",
            "telephone_number": "601-738-5565",
            "fax_number": "601-738-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HOLT COLLIER DR STE C",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391834408",
            "telephone_number": "601-738-5565",
            "fax_number": "601-738-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NULIFE HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-597-2362"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.