Organization
LIFE ENHANCEMENT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEMETRIUS JERMAINE CRAYTON (EXECUTIVE DIRECTOR)
(704) 299-2821
Entity
Organization
Contact information
Practice address
108 EASTSIDE ST., 103, TUSKEGEE, AL 36083-1701
(334) 727-1122
(334) 727-7277
Mailing address
108 EASTSIDE ST, 103, TUSKEGEE, AL 36083-1701
(334) 727-1122
(334) 727-7277
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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