LIFE NET SERVICES (NPI# 1629588496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629588496 |
| Entity Type | Organization |
| Organization Name | LIFE NET SERVICES |
| Practice Address |
2149 Valleygate Dr Ste 101 Fayetteville NC 28304 |
| Mailing Address |
1500 Laguardia Dr Hope Mills NC 28348-7010 |
| Practice Telephone | 9102072660 |
| Mailing Telephone | 9102072660 |
| Mailing Fax Number | 3364412353 |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | ALICIA CABBAGESTALK (PRESIDENT) |
| Authorized Official Telephone | 9102072660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
38415 | NC | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LIFE NET SERVICES LLC | 1790 Metromedical Dr, Fayetteville, NC 28304-3861 |
| Street Address |
2149 VALLEYGATE DR STE 101 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013362284 | Better Communities | Preferred Provider Organization | 2149 Valleygate Dr Ste 101, Fayetteville, NC 28304-3666 | 2016-04-25 |
| 1790297786 | Charlton Roberson | Counselor | 2149 Valleygate Dr Ste 101, Fayetteville, NC 28304-3666 | 2017-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508994351 | Eugene Lee | Psychiatry & Neurology | 4210 Frontage Road #10, Fayetteville, AR 72703 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1447725098 | Addictioncare 101 | Psychiatry & Neurology | 311 4 E Judges Road, Wilmington, NC 28405 | 2018-10-10 |
| 1942719950 | Peak Wellness Clinic Pllc | Psychiatry & Neurology | 5252 B N Sharon Amity Road, Charlotte, NC 28215 | 2017-09-21 |
| 1124446430 | Hien Ngoc Nguyen | Psychiatry & Neurology | 2172 N Salem St Ste 105, Apex, NC 27523-6457 | 2014-04-03 |
| 1467798520 | Sabina Benel | Psychiatry & Neurology | 5252b N Sharon Amity Rd, Charlotte, NC 28215-0053 | 2012-12-18 |
| 1518099910 | Nzinga Ajabu Harrison | Psychiatry & Neurology | 123 Professional Park Dr Ste 101, Mooresville, NC 28117-5516 | 2007-03-12 |
| 1962585513 | Elizabeth Shirley Stanton | Psychiatry & Neurology | 129 Mayo St, Hillsborough, NC 27278 | 2006-10-24 |
| 1548373525 | Marvin J Hoffert | Psychiatry & Neurology | 1011 Schaub Dr, Suite 201, Raleigh, NC 27606-1862 | 2006-08-16 |
| 1437162096 | Gregory Oran Dill | Psychiatry & Neurology | 932 Hendersonville Rd Ste 105c, Asheville, NC 28803-6628 | 2006-08-14 |
| 1538183942 | Gary G. Leonhardt | Psychiatry & Neurology | 203 Government Cir, Greenville, NC 27834-8198 | 2006-07-27 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on LIFE NET SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.