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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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