| Life Recovery Services Pllc | |
|
1503-h Wayne Memorial Dr Goldsboro NC 27534 | |
| (919) 330-4576 | |
| (919) 581-5017 |
| Full Name | Life Recovery Services Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1503-h Wayne Memorial Dr, Goldsboro, North Carolina |
| Authorized Official Name and Position | Madonna Brown (OWNER) |
| Authorized Official Contact | 9193304576 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Recovery Services Pllc Po Box 10494 Goldsboro NC 27532-0494 Ph: (919) 330-4576 | Life Recovery Services Pllc 1503-h Wayne Memorial Dr Goldsboro NC 27534 Ph: (919) 330-4576 |
| NPI Number | 1538582259 |
|---|---|
| Provider Enumeration Date | 01/31/2014 |
| Last Update Date | 01/31/2014 |
| Medicare PECOS PAC ID | 6608227814 |
|---|---|
| Medicare Enrollment ID | O20240111002127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538582259 | NPI | - | NPPES |
| 6104118 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (North Carolina) | Primary |
| Provider Name | Madonna Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396982880 PECOS PAC ID: 8325499536 Enrollment ID: I20240111002279 |
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