LIFE INC. NPI 1750435111

NPI Information

  • NPI: 1750435111
  • Provider Name: LIFE, INC.
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • CLIA Number: 34D2284921
  • Address: 407 N WILLIAM ST
    GOLDSBORO, NC
    ZIP 27530
  • Phone: (919) 734-1402

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NPI Details

LIFE, INC. is an intermediate care facility mentally retarded in Goldsboro, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. LIFE, INC. NPI is 1750435111. The provider is registered as an organization entity type.

The provider's business location address is:

407 N WILLIAM ST
GOLDSBORO, NC
ZIP 27530-801
Phone: (919) 734-1402
Fax: (919) 583-8210

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 34D2284921 - intermediate care facility for mentally retarded 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
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesMHL-096-003NORTH CAROLINAYes

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
1922100OTHERNORTH CAROLINASTATE FACILITY ID
23416319MEDICAIDNORTH 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: 3/30/2025

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