Organization
WORD OF LIFE OUTEACH, INC
Active
Organization
WORD OF LIFE OUTEACH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY A JOHNSON B. A. (ADMINISTRATOR)
(910) 371-5300
Entity
Organization
Contact information
Practice address
9781 BLACKWELL RD SE, LELAND, NC 28451-8519
(910) 371-5300
(910) 371-5302
Mailing address
PO BOX 661, LELAND, NC 28451-0661
(910) 371-5300
(910) 371-5302
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-010-045
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-010-048
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-010-049
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-065-164
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603477
—
NC
05
—
6603673
—
NC
05
—
6603769
—
NC
05
—
6603942
—
NC
05
—
8301346
—
NC
Enumeration date
02/20/2007
Last updated
09/11/2025
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