LIFE FULFILLMENT AND WELLNESS LLC NPI 1619540077

NPI Information

NPI: 1619540077
Provider Name: LIFE FULFILLMENT AND WELLNESS LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4335 W PIEDRAS DR STE 103
SAN ANTONIO, TX
ZIP 78228
Phone: (210) 600-4117
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LIFE FULFILLMENT AND WELLNESS LLC is a mental health counselor in San Antonio, TX. LIFE FULFILLMENT AND WELLNESS LLC NPI is 1619540077. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4335 W PIEDRAS DR STE 103
SAN ANTONIO, TX
ZIP 78228-215
Phone: (210) 600-4117
Fax: (210) 600-3849

The provider's authorized official is Imelda Ramirez Reveron .
The authorized official title is Ceo/administrator and has the following contact phone number (210) 600-4117.

The enumeration date for this NPI number is 7/22/2021 and was last updated on 7/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes
2	207Q00000X	Family Medicine				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1144893694	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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