Organization
TRANSFORMATIVE LIFE CENTER, LLC.
Active
Organization
TRANSFORMATIVE LIFE CENTER, LLC.
Active
Parent organization
TRANSFORMATIVE LIFE CENTER, LLC.
Other names
Senior Health Source
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRANSFORMATIVE LIFE CENTER, LLC.
Authorized official
MR. LEWIS EVANS (OWNER)
(877) 747-5520
Entity
Organization
Contact information
Practice address
3440 TORINGDON WAY, SUITE 205, CHARLOTTE, NC 28277-3190
(877) 747-5520
(877) 539-5520
Mailing address
3440 TORINGDON WAY, SUITE 205, CHARLOTTE, NC 28277-3190
(877) 747-5520
(877) 539-5520
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3909
NC
Other
Enumeration date
10/06/2010
Last updated
10/06/2010
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