Organization
LIFE ENHANCEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERB GRAY (CEO)
(704) 560-4332
Entity
Organization
Contact information
Practice address
889 N LIBERTY ST, WINSTON SALEM, NC 27101-3040
(704) 560-4332
(704) 342-9584
Mailing address
889 N LIBERTY ST, WINSTON SALEM, NC 27101-3040
(704) 560-4332
(704) 342-9584
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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