Organization
LIFE, INC.
Active
Parent organization
LIFE, INC.
Other names
Luke Street Facility - Edenton
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
200 LUKE ST, EDENTON, NC 27932-9614
(919) 734-4386
Mailing address
2609 ROYALL AVE, GOLDSBORO, NC 27534-8615
(919) 778-1900
(919) 778-1972
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-021-013
NC
343900000X
Non-emergency Medical Transport (VAN)
MHL-021-013
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MHL-021-013
—
NC
Enumeration date
02/08/2007
Last updated
07/21/2022
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