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NPI Code Detail

MEDICARE: LIFE ENHANCEMENT SERVICES

MEDICARE: LIFE ENHANCEMENT SERVICES
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1578420600
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE ENHANCEMENT SERVICES
Provider Business Mailing Address
First Line : 1809 ABERDEEN CIR
Second Line :
City : CROFTON
State : MD
Zip : 21114-1619
Country : US
Telephone Number : 240-398-6197
Fax Number :
Provider Business Practice Location Address
First Line : 1301 LENFANT SQ SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-6724
Country : US
Telephone Number : 202-269-2401
Fax Number :
Authorized Official
Title or Position : COMMUNITY SUPPORT WORKER
Name : NICOLA TUCKER-BEY
Credential :
Telephone Number : 240-398-6197
Provider Enumeration Date : 01/09/2026
Last Update Date : 01/09/2026

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Directions to “LIFE ENHANCEMENT SERVICES ” Practice Location

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