Organization
ENVISIONS OF LIFE LLC
Active
Organization
ENVISIONS OF LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TOMEKO M MOORE LCAS, LCSWA (PRESIDENT)
(336) 887-0708
Entity
Organization
Contact information
Practice address
449 W MAIN ST, JONESVILLE, NC 28642-2130
(336) 887-0708
(336) 887-1085
Mailing address
5 CENTERVIEW DR STE 110, GREENSBORO, NC 27407-3709
(336) 887-0708
(336) 887-1085
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
099-029
NC
Other
Enumeration date
10/20/2016
Last updated
09/01/2017
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