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General NPI Number Information
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NPI Number | 1851522619
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Entity Type | Organization
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Legal Business Name | LIFE OPPORTUNITIES INC
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 1002 E 4TH AVE STE B
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City | RED SPRINGS
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State | NC
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Zip | 28377-1642
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Country | US
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Telephone | 910-843-1105
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Fax | 910-843-1295
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Provider Business Mailing Address
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Address Line | PO BOX 448
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City | SHANNON
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State | NC
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Zip | 28386-0448
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Country | US
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Telephone | 919-302-8990
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Fax | 910-843-1295
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONALD R MCMILLAN
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Credential |
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Telephone | 919-302-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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