| Life Enhancement Services Of Va, Llc | |
|
1328 Southern Ave Se Suite 301 Washington DC 20032-4689 | |
| (877) 845-8169 | |
| Not Available |
| Full Name | Life Enhancement Services Of Va, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1328 Southern Ave Se, Washington, District Of Columbia |
| Authorized Official Name and Position | Herbert Gray (CEO) |
| Authorized Official Contact | 7043429595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Enhancement Services Of Va, Llc 500 E Morehead St Suite 110 Charlotte NC 28202-2616 Ph: (704) 342-9595 | Life Enhancement Services Of Va, Llc 1328 Southern Ave Se Suite 301 Washington DC 20032-4689 Ph: (877) 845-8169 |
| NPI Number | 1336485366 |
|---|---|
| Provider Enumeration Date | 12/19/2012 |
| Last Update Date | 12/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336485366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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