Organization
LIFE ENHANCEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERB GRAY III (OWNER)
(919) 956-7176
Entity
Organization
Contact information
Practice address
401 E 11TH ST, LUMBERTON, NC 28358-4807
(910) 738-4000
(910) 738-4067
Mailing address
411 W CHAPEL HILL ST, SUITE 902, DURHAM, NC 27701-3616
(919) 956-7176
(919) 682-2339
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301381
—
NC
Enumeration date
12/12/2006
Last updated
03/20/2009
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