Provider Demographics
NPI:1386321842
Name:ENCOMPASS LIFE LLC
Entity type:Organization
Organization Name:ENCOMPASS LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENYAH
Authorized Official - Middle Name:SHADAWN
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-906-3777
Mailing Address - Street 1:4000 PARKSIDE CENTER BLVD APT 1501
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4393
Mailing Address - Country:US
Mailing Address - Phone:918-906-3777
Mailing Address - Fax:
Practice Address - Street 1:4000 PARKSIDE CENTER BLVD APT 1501
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-4393
Practice Address - Country:US
Practice Address - Phone:918-906-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management