Organization
LIFE ENHANCEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERB GRAY III (OWNER)
(919) 956-7176
Entity
Organization
Contact information
Practice address
1225 E 5TH ST, SUITE 203, WINSTON SALEM, NC 27101-4315
(336) 777-1217
(336) 777-1218
Mailing address
411 W CHAPEL HILL ST, SUITE 902, DURHAM, NC 27701-3616
(919) 956-7176
(919) 682-2339
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301361
—
NC
Enumeration date
12/12/2006
Last updated
08/22/2020
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