Provider Demographics
NPI:1891921870
Name:LIFE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:LIFE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-640-7602
Mailing Address - Street 1:2018 FORT BRAGG RD
Mailing Address - Street 2:STE 114A
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-7037
Mailing Address - Country:US
Mailing Address - Phone:910-640-7602
Mailing Address - Fax:
Practice Address - Street 1:820 E PARK AVE
Practice Address - Street 2:STE E-100
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2610
Practice Address - Country:US
Practice Address - Phone:910-640-7602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health