| Envisions Of Life Llc | |
|
5 Centerview Drive Suite 110 Greensboro NC 27407-3709 | |
| (336) 887-0708 | |
| (336) 887-1085 |
| Full Name | Envisions Of Life Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5 Centerview Drive, Greensboro, North Carolina |
| Authorized Official Name and Position | Tomeko Michelle Moore (PRESIDENTE) |
| Authorized Official Contact | 3368870708 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Envisions Of Life Llc 5 Centerview Drive Suite 110 Greensboro NC 27407-3079 Ph: (336) 887-0708 | Envisions Of Life Llc 5 Centerview Drive Suite 110 Greensboro NC 27407-3709 Ph: (336) 887-0708 |
| NPI Number | 1013261957 |
|---|---|
| Provider Enumeration Date | 10/30/2012 |
| Last Update Date | 03/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013261957 | NPI | - | NPPES |
| 5908655 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (North Carolina) | Secondary |
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