Organization
LIFE ENHANCEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT GRAY (MANAGER)
(704) 560-4332
Entity
Organization
Contact information
Practice address
1818 NEW YORK AVE NE STE 115, WASHINGTON, DC 20002-1851
(202) 269-2401
(202) 269-2402
Mailing address
13016 EASTFIELD RD STE 200-269, HUNTERSVILLE, NC 28078-6622
(704) 560-4332
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050018500
—
DC
Enumeration date
03/30/2015
Last updated
03/28/2019
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