Organization
LIFE DOMAINS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TOYA STEPHENS (OWNER)
(336) 269-4048
Entity
Organization
Contact information
Practice address
1656 NORTH GLENCOE ROAD, BURLINGTON, NC 27215
(336) 269-4048
Mailing address
1146 N CHURCH ST, SUITE G, BURLINGTON, NC 27217-2702
(336) 269-4048
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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