Organization
BACK 2 LYFE OUTREACH SERVICES, INC
Active
Other names
Back 2 Lyfe Outreach Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LASHAUNA APRIL GRIER (PROGRAM DIRECTOR)
(443) 286-7850
Entity
Organization
Contact information
Practice address
1914 J N PEASE PL, CHARLOTTE, NC 28262-4504
(980) 292-3213
Mailing address
109 STOCK LN, MOORESVILLE, NC 28115-9720
(980) 292-3213
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/19/2023
Last updated
07/27/2023
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