Organization
LIFE ADVANCEMENT SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NETTIE ROSE CLARKE MS, LPC, LCAS-A, (OWNER)
(336) 383-9932
Entity
Organization
Contact information
Practice address
1332 CUSHING ST, 1108 GRACADE STREET, GREENSBORO, NC 27405-3322
(336) 383-9932
Mailing address
1332 CUSHING STREET, 1108 GRACADE STREET, GREENSBORO, NC 27408
(336) 383-9932
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10171
NC
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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