Organization
LIFE, INC.
Active
Parent organization
LIFE, INC.
Other names
Wickham Road Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE, INC.
Authorized official
JAMES WALKER (DIRECTOR OF CONTRACT SERVICES)
(919) 778-1900
Entity
Organization
Contact information
Practice address
258 WICKHAM RD, SHILOH, NC 27974-7222
(252) 336-4142
(252) 336-2372
Mailing address
2609 ROYALL AVE, GOLDSBORO, NC 27534-8615
(919) 778-1900
(919) 778-2920
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-015-004
NC
343900000X
Non-emergency Medical Transport (VAN)
MHL-015-004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805689
—
NC
Enumeration date
02/08/2007
Last updated
12/15/2017
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