Organization
LIFE ENHANCEMENT SERVICES OF SC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT GRAY (CEO OWNER)
(980) 265-1064
Entity
Organization
Contact information
Practice address
3040 E HIGHWAY 76, STE 111, MULLINS, SC 29574-7396
(980) 265-1064
Mailing address
9700 RESEARCH DR, STE 111, CHARLOTTE, NC 28262-8552
(980) 265-1064
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
07/20/2015
Last updated
07/20/2015
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