# LIFE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WILSON DDA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700418225
- **Authorized official:** RICHARD LYNN SMITH (VP OF BUSINESS OPERATIONS)
- **Authorized official phone:** (919) 778-1900

## Contact information

- **Practice address:** 505 HEMPHILL ST, STANTONSBURG, NC 27883-9011
- **Practice address phone:** (919) 778-1900
- **Practice address fax:** (919) 778-1972
- **Mailing address:** 2609 ROYALL AVE, GOLDSBORO, NC 27534-8615
- **Mailing address phone:** (919) 778-1900
- **Mailing address fax:** (919) 778-1972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/12/2020
- **Last updated:** 02/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3408694 | — | NC |