MEDICARE: NU LOOK ON LIFE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1245410117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NU LOOK ON LIFE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 30651
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27833-0651
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3011 S MEMORIAL DR
Second Line	:	SUITE 12
City	:	GREENVILLE
State	:	NC
Zip	:	27834-6238
Country	:	US
Telephone Number	:	252-258-0333
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. SHELIA LEGGETTE
Credential	:
Telephone Number	:	252-258-0333

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	12/08/2008

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Directions to “NU LOOK ON LIFE, LLC ” Practice Location

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