Provider Demographics
NPI:1801062468
Name:LIFE ENHANCEMENTS INC.
Entity type:Organization
Organization Name:LIFE ENHANCEMENTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:704-825-9696
Mailing Address - Street 1:32 N MAIN ST
Mailing Address - Street 2:BOX 214
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3162
Mailing Address - Country:US
Mailing Address - Phone:704-825-9696
Mailing Address - Fax:866-880-8347
Practice Address - Street 1:32 N MAIN ST
Practice Address - Street 2:BOX 214
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3162
Practice Address - Country:US
Practice Address - Phone:704-825-9696
Practice Address - Fax:866-880-8347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3210101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102716Medicaid