FULL POTENTIAL LIFE LLC NPI 1568692127

NPI Information

FULL POTENTIAL LIFE LLC is an adult mental health clinic center in Durham, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. FULL POTENTIAL LIFE LLC NPI is 1568692127. The provider is registered as an organization entity type.

The provider's business location address is:

1530 N GREGSON ST
SUITE 3-D
DURHAM, NC
ZIP 27701-155
Phone: (919) 321-6171
Fax: (888) 805-6175

The provider's authorized official is Logan Graddy .
The authorized official title is Psychiatrist and has the following contact phone number (919) 321-6171.

The enumeration date for this NPI number is 7/16/2009 and was last updated on 7/16/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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