Organization
A POSITIVE LIFE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER LEE YOUNG BS (DIRECTOR/OWNER)
(910) 223-7300
Entity
Organization
Contact information
Practice address
3108 DYKE ST, FAYETTEVILLE, NC 28306-2809
(910) 223-7300
(910) 323-3206
Mailing address
3108 DYKE ST, FAYETTEVILLE, NC 28306-2809
(910) 223-7300
(910) 323-3206
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-026742
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603408
—
NC
05
—
8301441
—
NC
Enumeration date
09/04/2009
Last updated
09/04/2009
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