Organization
LIFE ENHANCEMENT SERVICES OF MS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT GRAY III (CEO/OWNER)
(704) 342-9595
Entity
Organization
Contact information
Practice address
232 MARKET ST, FLOWOOD, MS 39232-3339
(704) 342-9595
Mailing address
500 E MOREHEAD ST, SUITE 110, CHARLOTTE, NC 28202-2616
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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