LIFETIME RESOURCES INC. NPI 1952516700

NPI Information

LIFETIME RESOURCES, INC. is an intermediate care facility mentally retarded in Wilmington, NC. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. LIFETIME RESOURCES, INC. NPI is 1952516700. The provider is registered as an organization entity type.
The provider Other Name Is Myrtle Grove Group Home.

The provider's business location address is:

6732 MYRTLE GROVE RD
WILMINGTON, NC
ZIP 28409-804
Phone: (910) 762-1189
Fax: (910) 762-1301

The provider's authorized official is Robert T. Thacker, Jr. .
The authorized official title is Executive Director and has the following contact phone number (910) 762-1189.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 7/7/2017.

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:

Other Identifiers

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

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