Organization
LIFE ENHANCEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT GRAY (CEO)
(704) 342-9595
Entity
Organization
Contact information
Practice address
2221 N 24TH ST, OMAHA, NE 68110-2200
(704) 342-9595
Mailing address
500 E. MOREHEAD ST, SUITE 110, CHARLOTTE, NC 28202
(704) 342-9595
(704) 342-9166
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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