Provider Demographics
NPI:1588940944
Name:COMMUNITY ENHANCEMENT SERVICES LLC
Entity type:Organization
Organization Name:COMMUNITY ENHANCEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:KENION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-538-3019
Mailing Address - Street 1:1108 GRECADE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8729
Mailing Address - Country:US
Mailing Address - Phone:336-285-9194
Mailing Address - Fax:336-285-9195
Practice Address - Street 1:1108 GRECADE STREET
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8729
Practice Address - Country:US
Practice Address - Phone:336-285-9194
Practice Address - Fax:336-285-9195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health