Provider Demographics
NPI:1447690656
Name:LIFE WELLNESS FOUNDATION LLC
Entity type:Organization
Organization Name:LIFE WELLNESS FOUNDATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONALI
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATIL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-788-5868
Mailing Address - Street 1:23142 SAN NICHOLAS PL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2506
Mailing Address - Country:US
Mailing Address - Phone:281-394-5650
Mailing Address - Fax:
Practice Address - Street 1:23142 SAN NICHOLAS PL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2506
Practice Address - Country:US
Practice Address - Phone:281-394-5650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care