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Organization
POSITIVE LIFE STYLES
Active
Organization
POSITIVE LIFE STYLES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS H REID (OWNER)
(252) 281-3967
Entity
Organization
Contact information
Practice address
4805 GREEN WING RD, WILSON, NC 27893-8142
(252) 281-3967
(252) 674-7060
Mailing address
4805 GREEN WING RD, WILSON, NC 27893-8142
(252) 281-3967
(252) 674-7060
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL098033
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FCL098033
PROVIDER LICENSE
NC
Enumeration date
11/14/2016
Last updated
11/14/2016
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