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WORD OF LIFE OUTEACH INC NPI 1952446619


NPI Information

NPI: 1952446619
Provider Name: WORD OF LIFE OUTEACH, INC
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
9781 BLACKWELL RD SE
LELAND, NC
ZIP 28451
Phone: (910) 371-5300
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WORD OF LIFE OUTEACH, INC is a residential treatment facility emotionally disturbed children in Leland, NC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. WORD OF LIFE OUTEACH, INC NPI is 1952446619. The provider is registered as an organization entity type.

The provider's business location address is:

9781 BLACKWELL RD SE
LELAND, NC
ZIP 28451-519
Phone: (910) 371-5300
Fax: (910) 371-5302

The provider's authorized official is Jeffery A Johnson .
The authorized official title is Administrator and has the following contact phone number (910) 371-5300.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 8/22/2020.


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
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-010-045NORTH CAROLINAYes
2322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-010-048NORTH CAROLINAX
3322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-010-049NORTH CAROLINAX
4322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-065-164NORTH CAROLINAX
5251B00000XCase ManagementNORTH CAROLINAX

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
16603769MEDICAIDNORTH CAROLINA
28301346MEDICAIDNORTH CAROLINA
36603477MEDICAIDNORTH CAROLINA
46603673MEDICAIDNORTH CAROLINA
56603942MEDICAIDNORTH CAROLINA

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

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