Organization
LIFE, INC.
Active
Parent organization
LIFE, INC.
Other names
LIFE, Inc./Lakeview
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
102 MIDWAY LN, ROANOKE RAPIDS, NC 27870-9568
(252) 535-4031
(252) 583-1615
Mailing address
PO BOX 446, HALIFAX, NC 27839-0446
(252) 535-4031
(252) 583-1615
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-042-010
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3416323
—
NC
01
—
922097
STATE FACILITY ID
NC
Enumeration date
01/22/2007
Last updated
12/15/2017
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