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General NPI Number Information
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NPI Number | 1891921870
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Entity Type | Organization
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Legal Business Name | LIFE SOLUTIONS, LLC
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Dates
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Enumeration Date | 06/04/2009
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 820 E PARK AVE STE E-100
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City | TALLAHASSEE
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State | FL
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Zip | 32301-2610
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Country | US
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Telephone | 910-640-7602
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Fax |
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Provider Business Mailing Address
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Address Line | 2018 FORT BRAGG RD STE 114A
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-7037
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Country | US
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Telephone | 910-640-7602
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BERNARD EVANS
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Credential |
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Telephone | 910-640-7602
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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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