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Organization
LIFE, INC.
Active
Organization
LIFE, INC.
Active
Parent organization
LIFE, INC.
Other names
LIFE, Inc./Albemarle Group Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE, INC.
Authorized official
RICHARD LYNN SMITH (VP OF BUSINESS OPERATIONS)
(919) 778-1900
Entity
Organization
Contact information
Practice address
243 COKE AVE, EDENTON, NC 27932-1522
(252) 482-7909
Mailing address
PO BOX 70, EDENTON, NC 27932-0070
(252) 482-8666
(252) 482-8881
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL021006
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340610R
—
NC
05
—
MHL-021-006
—
NC
Enumeration date
01/15/2007
Last updated
12/15/2017
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