# ENVISIONS OF LIFE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972700763
- **Authorized official:** MRS. TOMEKO MICHELLE MOORE (PRESIDENT)
- **Authorized official phone:** (336) 887-0708

## Contact information

- **Practice address:** 420 GULLEY ST, GOLDSBORO, NC 27530-5045
- **Practice address phone:** (336) 887-0708
- **Practice address fax:** (336) 887-1085
- **Mailing address:** 307 S SWING RD STE 5, GREENSBORO, NC 27409-2073
- **Mailing address phone:** (336) 887-0708
- **Mailing address fax:** (336) 887-1085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL 041 179 | NC | Yes |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 07/26/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6604062 | — | NC |