LIFE INC. NPI 1336293794

NPI Information

NPI: 1336293794
Provider Name: LIFE, INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
CLIA Number: 34D2237189
Address: 105 CHEROKEE TRL
WILMINGTON, NC
ZIP 28409
Phone: (910) 799-9517

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NPI Details

LIFE, INC. is an intermediate care facility mentally retarded in Wilmington, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. LIFE, INC. NPI is 1336293794. The provider is registered as an organization entity type.

The provider's business location address is:

105 CHEROKEE TRL
WILMINGTON, NC
ZIP 28409-407
Phone: (910) 799-9517
Fax: (910) 799-3680

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 CLIA number assigned to this NPI record is 34D2237189 - other - day program with a certificate type of Certificate of Waiver.

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-065-040	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	340608W	MEDICAID	NORTH CAROLINA
2	944598	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: 11/21/2025

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