Healthcare Provider Details

I. General information

NPI: 1427244177
Provider Name (Legal Business Name): LIFE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 04/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NORTH MAIN STREET
RED SPRINGS NC
28377-1512
US

IV. Provider business mailing address

2018 FORT BRAGG RD 114A
FAYETTEVILLE NC
28303-7037
US

V. Phone/Fax

Practice location:
  • Phone: 910-843-8125
  • Fax:
Mailing address:
  • Phone: 910-424-0500
  • Fax: 910-424-8300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARREA EVANS
Title or Position: OWNER
Credential:
Phone: 910-424-0500