LIFE, INC. (NPI# 1760522478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760522478 |
| Entity Type | Organization |
| Organization Name | LIFE, INC. |
| Other Organization Name | LUKE STREET FACILITY - EDENTON |
| Practice Address |
200 Luke St Edenton NC 27932-9614 |
| Mailing Address |
2609 Royall Ave Goldsboro NC 27534-8615 |
| Practice Telephone | 9197344386 |
| Mailing Telephone | (919) 778-1900 |
| Mailing Fax Number | 9197781972 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2017-12-15 |
| Authorized Official Name | JAMES WALKER (DIRECTOR OF CONTRACT SERVICES) |
| Authorized Official Telephone | 9197781900 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 343900000X | Non-emergency Medical Transport (VAN) | MHL-021-013 | NC | Transportation Services |
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
MHL-021-013 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MHL-021-013 | 05 |
| Other Name | Type Code |
|---|---|
| Luke Street Facility - Edenton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376059501 | Life, Inc. | Day Training, Developmentally Disabled Services | 701 N Broad St Ste D, Edenton, NC 27932-1462 | 2017-12-26 |
| 1023524345 | Life, Inc. | Community/Behavioral Health | 117j Village Rd Ne, Leland, NC 28451-7413 | 2017-12-22 |
| 1366958902 | Life, Inc. | Community/Behavioral Health | 706 S Mcdaniel St, Enfield, NC 27823-1757 | 2017-12-19 |
| 1902946882 | Life, Inc. | Non-emergency Medical Transport (VAN) | 139 Barnard Rd, Grandy, NC 27939-9629 | 2007-02-08 |
| 1356481220 | Life, Inc. | Non-emergency Medical Transport (VAN) | 258 Wickham Rd, Shiloh, NC 27974-7222 | 2007-02-08 |
| 1518007483 | Life, Inc. | Non-emergency Medical Transport (VAN) | 185 Roanoke Trl, Manteo, NC 27954-9598 | 2007-02-08 |
| 1851431704 | Life, Inc. | In Home Supportive Care | 2609 Royall Ave, Goldsboro, NC 27534-8615 | 2007-02-08 |
| 1134260797 | Life, Inc. | Non-emergency Medical Transport (VAN) | 700 Georgia Ave, Roanoke Rapids, NC 27870-3115 | 2007-02-08 |
| 1962542837 | Life, Inc. | Non-emergency Medical Transport (VAN) | 142 Riverwood Dr, Hertford, NC 27944-9784 | 2007-02-08 |
| 1639219488 | Life, Inc. | Community/Behavioral Health | 1829 Carolina Ave, Washington, NC 27889-3369 | 2007-02-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Life, Inc | 1800 E. Stanford Ave, Cherry Hills Village, CO 80113 |
| Street Address |
200 LUKE ST |
| City | EDENTON |
| State | NC |
| Zip Code | 27932-9614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598002172 | Ashley Nicole Brooke Miller | Counselor | 1255 Haughton Road, Edenton, NC 27932 | 2013-01-15 |
| 1629365341 | Columbia Chiropractic Center PC | Chiropractor | 187 La Keiser Dr, Columbia, NC 27932 | 2011-07-01 |
| 1760682579 | Edenton House, LLC | Assisted Living Facility | 323 Medical Arts Drive, Edenton, NC 27932 | 2007-07-19 |
| 1801913975 | Coastal Rehabilitation Inc | Physical Therapist | 701 Luke Street, Edenton, NC 27932 | 2007-03-23 |
| 1225164734 | Paul Stephen Richmond | Dentist | 410 N Broad Street, Edenton, NC 27932 | 2007-02-26 |
| 1003960816 | Albemarle Mental Health Center | Social Worker | 202 W Hicks Street, Edenton, NC 27932 | 2007-01-22 |
| 1679642532 | Womens Health of Edenton PC | Obstetrics & Gynecology | 309 N Broad Street, Edenton, NC 27932 | 2006-11-07 |
| 1184713505 | Jerry L Bradley | Dentist | 512 Coke Avenue, Edenton, NC 27932 | 2006-10-12 |
| 1457454126 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1316 H N Broad St, Edenton, NC 27932 | 2006-09-07 |
| 1972613321 | Joel Crist Reynolds | Urology | 210 N Broad St, Edenton Urology Clinic, Edenton, NC 27932 | 2006-08-30 |
| Find all providers in zip 27932 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790001246 | Edenton Retirement Community, LLC | Custodial Care Facility | 106 Mark Dr, Edenton, NC 27932-1756 | 2010-04-08 |
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| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
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| 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.