Organization
ENRICHMENT FOR LIFE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA CELESTE MULLEN LPN (EXECUTIVE DIRECTOR)
(919) 345-5847
Entity
Organization
Contact information
Practice address
1138 DREW ST, DURHAM, NC 27701-2702
(919) 667-1580
Mailing address
4501 NEW BERN AVE, SUITE 130-120, RALEIGH, NC 27610-1549
(919) 349-4206
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-032-470
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-032-470
NC
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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