Organization
LIFE ENHANCEMENT SERVICES OF MD, LLC
Active
Other names
Life Enhancement Services Maryland
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT GRAY III (CEO)
(202) 269-2401
Entity
Organization
Contact information
Practice address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5173
(202) 269-2401
Mailing address
1818 NEW YORK AVE NE STE 115, WASHINGTON, DC 20002-1851
(202) 269-2401
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/19/2021
Last updated
02/26/2023
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