Provider Demographics
NPI:1215252788
Name:REAL LIFE HEALTHCARE SYSTEMS, LLC
Entity type:Organization
Organization Name:REAL LIFE HEALTHCARE SYSTEMS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:MONTAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-201-9655
Mailing Address - Street 1:PO BOX 20595
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77720-0595
Mailing Address - Country:US
Mailing Address - Phone:361-664-4888
Mailing Address - Fax:361-664-4489
Practice Address - Street 1:4925 EVERHART RD STE 118
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-3962
Practice Address - Country:US
Practice Address - Phone:361-882-5900
Practice Address - Fax:361-882-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-28
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013315OtherSTATE LICENSE
TX001019123Medicaid
67-1654OtherMEDICARE PROVIDER NUMBER