WORD OF LIFE OUTEACH, INC (NPI# 1952446619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952446619 |
| Entity Type | Organization |
| Organization Name | WORD OF LIFE OUTEACH, INC |
| Practice Address |
9781 Blackwell Rd Se Leland NC 28451-8519 |
| Mailing Address |
Po Box 661 Leland NC 28451-0661 |
| Practice Telephone | 9103715300 |
| Practice Fax Number | 9103715302 |
| Mailing Telephone | 9103715300 |
| Mailing Fax Number | 9103715302 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JEFFERY A JOHNSON (ADMINISTRATOR) |
| Authorized Official Telephone | 9103715300 |
| Authorized Official Credential | B. A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-010-045 | NC | Residential Treatment Facilities |
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-010-048 | NC | Residential Treatment Facilities |
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-010-049 | NC | Residential Treatment Facilities |
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-065-164 | NC | Residential Treatment Facilities |
| X | 251B00000X | Case Management | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603769 | 05 | |
| NC | 8301346 | 05 | |
| NC | 6603477 | 05 | |
| NC | 6603673 | 05 | |
| NC | 6603942 | 05 |
| Street Address |
9781 BLACKWELL RD SE |
| City | LELAND |
| State | NC |
| Zip Code | 28451-8519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811427156 | Town of Leland | Ambulance | 1004 Village Rd, Leland, NC 28451 | 2017-06-19 |
| 1205389517 | Total Renal Care of North Carolina LLC | Clinic/Center | 1220 Magnolia Village Way, Leland, NC 28451 | 2016-08-03 |
| 1043696800 | William Sanders Sr. | Respite Care | 3043 Ramble Dr, Leland, NC 28451 | 2015-08-04 |
| 1457730707 | Devinn L Geeson | Dentist | 1215 Westgate Drive, Suite 180, Leland, NC 28451 | 2015-05-20 |
| 1740611706 | Mark C. Austin Omfs, Pllc | Oral & Maxillofacial Surgery | 2001 South Baxter Drive, Leland, NC 28451 | 2013-12-02 |
| 1750711123 | Donna Rose Hodnicki | Nurse Practitioner | 1132 East Cutler Crossing, Leland, NC 28451 | 2013-11-20 |
| 1992137996 | Abbey Jones Mcclanahan | Physical Therapist | 1003 Olde Waterford Way # B, Leland, NC 28451 | 2013-08-01 |
| 1306010780 | Walter B. Futch, Jr. Dds Pa | Dentist | 1006 Northgate Drive, Leland, NC 28451 | 2008-04-17 |
| 1639357429 | Sbh- Wilmington, LLC | Psychiatric Hospital | 2050 Mercantile Drive, Leland, NC 28451 | 2008-02-05 |
| 1396930137 | F.a.c. Group Homes, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 9485 Huckabee Ct, Leland, NC 28451 | 2007-09-13 |
| Find all providers in zip 28451 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396930137 | F.a.c. Group Homes, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 9485 Huckabee Ct, Leland, NC 28451 | 2007-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| 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.