Organization
LIFE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WALKER (DIRECTOR OF CONTRACT SERVICES)
(919) 778-1900
Entity
Organization
Contact information
Practice address
2717 NEUSE BLVD, NEW BERN, NC 28562-2840
(252) 636-1090
Mailing address
2609 ROYALL AVE, GOLDSBORO, NC 27534-8615
(919) 778-1900
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
HC1543
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300732H
—
NC
Enumeration date
06/30/2009
Last updated
06/30/2009
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