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General NPI Number Information
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NPI Number | 1689332876
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Entity Type | Organization
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Legal Business Name | LIFE MIND ALLIANCE
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Dates
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Enumeration Date | 12/04/2021
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1301 N MAIN ST
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City | HIGH POINT
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State | NC
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Zip | 27262-3128
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Country | US
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Telephone | 743-229-3412
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Fax | 743-229-3807
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Provider Business Mailing Address
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Address Line | 1301 N MAIN ST
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City | HIGH POINT
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State | NC
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Zip | 27262-3128
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Country | US
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Telephone | 743-229-3412
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Fax | 743-229-3807
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | LARISA ROLLINS KING
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Credential | PMHNP-BC
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Telephone | 743-229-3412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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