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
1829 CAROLINA AVE, WASHINGTON, NC 27889-3369
(252) 974-2600
(252) 974-1211
Mailing address
2609 ROYALL AVE, GOLDSBORO, NC 27534-8615
(919) 778-1900
(919) 778-2920
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
HC1543
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408694
—
NC
Enumeration date
02/08/2007
Last updated
12/16/2017
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