MEDICARE: LIFE OPPORTUNITIES INC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1851522619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE OPPORTUNITIES INC

Provider Business Mailing Address
First Line	:	PO BOX 448
Second Line	:
City	:	SHANNON
State	:	NC
Zip	:	28386-0448
Country	:	US
Telephone Number	:	919-302-8990
Fax Number	:	910-843-1295

Provider Business Practice Location Address
First Line	:	1002 E 4TH AVE STE B
Second Line	:
City	:	RED SPRINGS
State	:	NC
Zip	:	28377-1642
Country	:	US
Telephone Number	:	910-843-1105
Fax Number	:	910-843-1295

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DONALD R MCMILLAN
Credential	:
Telephone Number	:	919-302-8990

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	12/18/2012

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Directions to “LIFE OPPORTUNITIES INC ” Practice Location

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