Organization
LIFE ENHANCEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERB GRAY (OWNER)
(704) 342-9595
Entity
Organization
Contact information
Practice address
701 E 2ND AVE, SUITE 5, GASTONIA, NC 28054-7144
(704) 342-9595
Mailing address
500 E MOREHEAD ST, 110, CHARLOTTE, NC 28202-2616
(704) 342-9595
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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