NPIMap

Organization Active NPI

Life Enhancement Services

  • Case Management Agency
  • Winston Salem, NC
National Provider Identifier
1275694739
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
LIFE ENHANCEMENT SERVICES
Practice address
1225 E 5TH St
Suite 203
Winston Salem, NC 27101-4315
Phone
(336) 777-1217
Fax
(336) 777-1218
NPI assigned
Dec 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Herb Gray III
Title
Owner
Phone
(919) 956-7176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NC Primary

Addresses

Primary practice location

1225 E 5TH St
Suite 203
Winston Salem, NC 27101-4315

Mailing address

411 W Chapel Hill St
Suite 902
Durham, NC 27701-3616
Phone (919) 956-7176

Other identifiers 1

IdentifierTypeStateIssuer
8301361MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Life Enhancement Services23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1225 E 5th St
Ste 203
Winston Salem, NC 27101
Phone (336) 777-1217

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275694739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W CHAPEL HILL ST",
            "address_2": "SUITE 902",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013616",
            "telephone_number": "919-956-7176",
            "fax_number": "919-682-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E 5TH ST",
            "address_2": "SUITE 203",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014315",
            "telephone_number": "336-777-1217",
            "fax_number": "336-777-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ENHANCEMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "HERB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-956-7176",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301361",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.