Lifetime Wellness Community Outreach LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

LIFETIME WELLNESS COMMUNITY OUTREACH LLC

Practice address

14809 Ralston Rd
Humble, TX 77396-5142

Phone

(214) 709-5615

NPI assigned

Jun 29, 2026

Last updated

Jul 1, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Osaze IdumwonyiNPI 1326913906

Title

CHW/Community Health Worker

Phone

(214) 709-5615

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Osaze Idumwonyi

  • Community Health Worker
  • Houston, TX
  • NPI 1326913906
  NPD (past) Authorized official

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

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1508782905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 W 43RD ST UNIT 1121",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770184202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14809 RALSTON RD",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773965142",
            "telephone_number": "214-709-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME WELLNESS COMMUNITY OUTREACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "IDUMWONYI",
        "authorized_official_first_name": "OSAZE",
        "authorized_official_title_or_position": "CHW/COMMUNITY HEALTH WORKER",
        "authorized_official_telephone_number": "214-709-5615",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Humble, TX
• Providers in Humble, TX by specialty
• Community Health Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.