Organization
LIFE ENHANCEMENT SERVICES OF NV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT A GRAY III (CEO)
(704) 560-4332
Entity
Organization
Contact information
Practice address
500 E MOREHEAD ST, STE 110, CHARLOTTE, NC 28202-2616
(704) 342-9595
Mailing address
500 E MOREHEAD ST, STE 110, CHARLOTTE, NC 28202-2616
(704) 342-9595
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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