Organization
LIFE ENHANCEMENT SERVICES OF OK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT GRAY (CEO/OWNER)
(704) 342-9595
Entity
Organization
Contact information
Practice address
9700 RESEARCH DR, SUITE 111, CHARLOTTE, NC 28262-8552
(704) 342-9595
Mailing address
9700 RESEARCH DR, SUITE 111, CHARLOTTE, NC 28262-8552
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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