Organization · NPI-2

Life, INC.

Custodial Care Facility, Adult Care Home · Roanoke Rapids, NC

NPI number1245370212

StatusActive

Last updated in NPPESDec 15, 2017

Details

NPI: 1245370212
Entity type: Organization (NPI-2)
Legal business name: Life, INC.
Organization subpart: Yes
Enumeration date: Feb 7, 2007
Last updated: Dec 15, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
311ZA0620X	Custodial Care Facility, Adult Care Home	MHL-042-001	NC	Yes
343900000X	Non-emergency Medical Transport (VAN)	MHL-042-001	NC

Practice location

105 Deerfield Pl
Roanoke Rapids, NC 27870-3305

Phone 919-778-1900

Mailing address

2609 Royall Ave
Goldsboro, NC 27534-8615

Phone 919-778-1900 · Fax 919-778-1972

Authorized official

Richard Lynn Smith
Vp Of Business Operations
9197781900

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