Provider Demographics
NPI:1437326576
Name:ENRICHED HEALTH SERVICES
Entity Type:Organization
Organization Name:ENRICHED HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BULLOCK-BLOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-215-1186
Mailing Address - Street 1:240 GREENVILLE BLVD SW STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4656
Mailing Address - Country:US
Mailing Address - Phone:252-215-1186
Mailing Address - Fax:252-215-1187
Practice Address - Street 1:240 GREENVILLE BLVD SW STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4656
Practice Address - Country:US
Practice Address - Phone:252-215-1186
Practice Address - Fax:252-215-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management