Organization
LIFE CHAMPIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARNOLD LEROY GAINES JR. (OWNER)
(336) 601-1967
Entity
Organization
Contact information
Practice address
2007 LYNN RD, GREENSBORO, NC 27405-6519
(336) 601-1967
Mailing address
2007 LYNN RD, GREENSBORO, NC 27405-6519
(336) 601-1967
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
06/15/2022
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