MODERATE LIVING FOR THE AGING INC NPI 1609233295

NPI Information

  • NPI: 1609233295
  • Provider Name: MODERATE LIVING FOR THE AGING INC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: MT. GILEAD INDEPENDENT SENIOR AND ASSISTED LIVING
  • CLIA Number: 34D2136935
  • Address: 110 ROOSEVELT ST
    MOUNT GILEAD, NC
    ZIP 27306
  • Phone: (910) 439-1635

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NPI Details

MODERATE LIVING FOR THE AGING INC is a clinic center in Mount Gilead, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MODERATE LIVING FOR THE AGING INC NPI is 1609233295. The provider is registered as an organization entity type.
The provider Is Doing Business As Mt. Gilead Independent Senior And Assisted Living.

The provider's business location address is:

110 ROOSEVELT ST
MOUNT GILEAD, NC
ZIP 27306-606
Phone: (910) 439-1635

The provider's authorized official is Mystery E Willis .
The authorized official title is Ceo and has the following contact phone number (910) 439-1669.

The CLIA number assigned to this NPI record is 34D2136935 - other - outpatient with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/27/2016 and was last updated on 12/1/2021.

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
1261Q00000XClinic/Center90368NORTH CAROLINAYes
2310400000XAssisted Living Facility902768NORTH CAROLINANo
3347E00000XTransportation BrokerNo

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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