# POSITIVE LIFE STYLES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013459643
- **Authorized official:** IRIS H REID (OWNER)
- **Authorized official phone:** (252) 281-3967

## Contact information

- **Practice address:** 4805 GREEN WING RD, WILSON, NC 27893-8142
- **Practice address phone:** (252) 281-3967
- **Practice address fax:** (252) 674-7060
- **Mailing address:** 4805 GREEN WING RD, WILSON, NC 27893-8142
- **Mailing address phone:** (252) 281-3967
- **Mailing address fax:** (252) 674-7060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL098033 | NC | Yes |

## Other

- **Enumeration date:** 11/14/2016
- **Last updated:** 11/14/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | FCL098033 | PROVIDER LICENSE | NC |