Provider Demographics
NPI:1699196741
Name:ANDREW A. DINKINS ENTERPRISES
Entity Type:Organization
Organization Name:ANDREW A. DINKINS ENTERPRISES
Other - Org Name:LIFE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:A
Authorized Official - Last Name:DINKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-734-8444
Mailing Address - Street 1:1008 BROOKSTOWN AVE
Mailing Address - Street 2:C1
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2562
Mailing Address - Country:US
Mailing Address - Phone:336-734-8444
Mailing Address - Fax:
Practice Address - Street 1:1008 BROOKSTOWN AVE
Practice Address - Street 2:C1
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2562
Practice Address - Country:US
Practice Address - Phone:336-734-8444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health