| Life Enrichment Services Center | |
|
208 S Bond Street Rowland NC 28383 | |
| (910) 422-3100 | |
| Not Available |
| Full Name | Life Enrichment Services Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 208 S Bond Street, Rowland, North Carolina |
| Authorized Official Name and Position | Hazel Wilson (OWNER) |
| Authorized Official Contact | 9104223100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Enrichment Services Center Po Box 1085 Rowland NC 28383-1085 Ph: (910) 422-3100 | Life Enrichment Services Center 208 S Bond Street Rowland NC 28383 Ph: (910) 422-3100 |
| NPI Number | 1255693438 |
|---|---|
| Provider Enumeration Date | 06/13/2012 |
| Last Update Date | 06/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255693438 | NPI | - | NPPES |
| 6007592 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C006810 (North Carolina) | Primary |
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