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General NPI Number Information
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NPI Number | 1629588496
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Entity Type | Organization
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Legal Business Name | LIFE NET SERVICES
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 1014 HAY ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5316
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Country | US
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Telephone | 910-745-8895
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Fax | 910-758-8254
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Provider Business Mailing Address
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Address Line | PO BOX 87024
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-7024
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Country | US
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Telephone | 910-745-8895
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Fax | 910-758-8254
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALICIA ROBERSON
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Credential |
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Telephone | 107-458-8895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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