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General NPI Number Information
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NPI Number | 1386882744
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Entity Type | Organization
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Legal Business Name | ENRICHMENT LIVING
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 400 N ELM ST
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City | WILLIAMSTON
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State | NC
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Zip | 27892-2016
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Country | US
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Telephone | 252-792-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 302 S WATTS ST
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City | WILLIAMSTON
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State | NC
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Zip | 27892-2446
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Country | US
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Telephone | 252-792-7820
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TAMEKIA P WILLIAMS
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Credential | N/A
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Telephone | 252-792-7820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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