Provider Demographics
NPI:1538736384
Name:ENRICHED LIVES HEALTH SERVICES
Entity type:Organization
Organization Name:ENRICHED LIVES HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OYINLOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUDIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-867-6822
Mailing Address - Street 1:24044 CINCO VILLAGE CENTER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:832-323-4220
Practice Address - Street 1:24044 CINCO VILLAGE CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8433
Practice Address - Country:US
Practice Address - Phone:832-323-4221
Practice Address - Fax:832-323-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty