Organization
FRUIT OF LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAOMI MICHELLE MILLER (OWNER)
(980) 333-8883
Entity
Organization
Contact information
Practice address
14110 WATERLYN DR, CHARLOTTE, NC 28278-7662
(980) 333-3883
Mailing address
513 N HICKORY ST, PAGELAND, SC 29728-1710
(980) 333-3883
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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