Organization
LYFE CHANGING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AIOFIMI S. BLACK (OWNER)
(910) 848-5855
Entity
Organization
Contact information
Practice address
120 MAYFLOWER LN, RAEFORD, NC 28376-9799
(910) 848-5855
(910) 848-5797
Mailing address
120 MAYFLOWER LN, RAEFORD, NC 28376-9799
(910) 848-5855
(910) 848-5797
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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