Organization
LIFE, INC.
Active
Parent organization
LIFE, INC.
Other names
LIFE, Inc./Nine Foot Road Group Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE, INC.
Authorized official
RICHARD LYNN SMITH (SENIOR VICE PRESIDENT/CFO)
(919) 778-1900
Entity
Organization
Contact information
Practice address
1229 NINE FOOT RD, NEWPORT, NC 28570-7017
(252) 223-3774
(252) 223-4053
Mailing address
PO BOX 973, NEW BERN, NC 28563-0973
(252) 636-1090
(252) 636-1725
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-016-012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340606F
—
NC
01
—
944844
STATE FACILITY ID
NC
Enumeration date
01/23/2007
Last updated
07/14/2023
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