Organization
LIFE, INC.
Active
Parent organization
LIFE, INC.
Other names
Halifax Co. Day Program
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
706 S MCDANIEL ST, ENFIELD, NC 27823-1757
(252) 445-1590
(252) 445-1592
Mailing address
2609 ROYALL AVE, GOLDSBORO, NC 27534-8615
(919) 778-1900
(919) 778-1972
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-042-067
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408694
—
NC
Enumeration date
12/19/2017
Last updated
12/19/2017
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