Organization
LIFE ENHANCEMENT SERVICES OF LOUISIANA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERB A GRAY III (CEO/OWNER)
(704) 560-4332
Entity
Organization
Contact information
Practice address
3677 FLORIDA BLVD, BATON ROUGE, LA 70806-3843
(704) 516-6046
Mailing address
230 S TRYON ST UNIT 1010, CHARLOTTE, NC 28202-3260
(704) 560-4332
(704) 342-9584
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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