LIFE INC. NPI 1245384601

NPI Information

NPI: 1245384601
Provider Name: LIFE, INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
249 COKE AVE
EDENTON, NC
ZIP 27932
Phone: (252) 482-5357
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LIFE, INC. is an intermediate care facility mentally retarded in Edenton, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. LIFE, INC. NPI is 1245384601. The provider is registered as an organization entity type.

The provider's business location address is:

249 COKE AVE
EDENTON, NC
ZIP 27932-522
Phone: (252) 482-5357
Fax: (252) 482-8881

The provider's authorized official is Richard Lynn Smith .
The authorized official title is Vp Of Business Operations and has the following contact phone number (919) 778-1900.

The enumeration date for this NPI number is 1/23/2007 and was last updated on 12/15/2017.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		MHL-021-007	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	340610P	MEDICAID	NORTH CAROLINA
2	955734	OTHER	NORTH CAROLINA	STATE FACILITY ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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