Envisions Of Life Llc | |
5 Centerview Drive Suite 110 Greensboro NC 27407-3709 | |
(336) 887-0708 | |
(336) 887-1085 |
Full Name | Envisions Of Life Llc |
---|---|
Speciality | Counselor - Mental Health |
Location | 5 Centerview Drive, Greensboro, North Carolina |
Authorized Official Name and Position | Tomeko Michelle Moore (PRESIDENTE) |
Authorized Official Contact | 3368870708 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Envisions Of Life Llc 5 Centerview Drive Suite 110 Greensboro NC 27407-3079 Ph: (336) 887-0708 | Envisions Of Life Llc 5 Centerview Drive Suite 110 Greensboro NC 27407-3709 Ph: (336) 887-0708 |
NPI Number | 1013261957 |
---|---|
Provider Enumeration Date | 10/30/2012 |
Last Update Date | 03/25/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013261957 | NPI | - | NPPES |
5908655 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (North Carolina) | Secondary |
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