Organization
ENRICHED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR M MOLINA (CEO)
(252) 641-1749
Entity
Organization
Contact information
Practice address
104 E GRANVILLE ST, TARBORO, NC 27886-5002
(252) 641-1749
Mailing address
104 E GRANVILLE ST, TARBORO, NC 27886-5002
(252) 641-1749
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-074-172
NC
Other
Enumeration date
12/27/2006
Last updated
07/23/2009
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