Organization
LIFE ENRICHMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ARETHA L BALL (DIRECTOR)
(205) 339-8300
Entity
Organization
Contact information
Practice address
9100 BAPTIST CAMPGROUND RD, SUITE B, NORTHPORT, AL 35473-8075
(205) 242-3577
Mailing address
9100 BAPTIST CAMPGROUND RD, SUITE B, NORTHPORT, AL 35473-8075
(205) 242-3577
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
G8357354H
AL
Other
Enumeration date
10/29/2007
Last updated
10/29/2007
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