Organization
LIFE ENHANCEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERB GRAY (CEO)
(704) 560-4332
Entity
Organization
Contact information
Practice address
5326 W BELLFORT ST, SUITE 110, HOUSTON, TX 77035-3041
(713) 859-8039
Mailing address
500 E MOREHEAD ST, SUITE 110, CHARLOTTE, NC 28202-2616
(704) 342-9595
(704) 342-9584
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
19312
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
19312
TX
101YM0800X
Mental Health Counselor
19312
TX
101YP2500X
Professional Counselor
19312
TX
101YS0200X
School Counselor
19312
TX
106H00000X
Marriage & Family Therapist
19312
TX
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/02/2010
Last updated
12/01/2010
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