Organization
LIFE ENRICHMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZI KENNEDY RN (EXECUTIVE DIRECTOR)
(704) 484-0405
Entity
Organization
Contact information
Practice address
103 T R HARRIS DR, SHELBY, NC 28150-3486
(704) 484-0405
(704) 484-0406
Mailing address
103 TR HARRIS DRIVE, SHELBY, NC 28150
(704) 484-0405
(704) 484-0406
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408527
—
NC
Enumeration date
06/21/2007
Last updated
08/22/2020
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