LIFE, INC.
Adult Care Home
Edenton, North Carolina
Provider NPI: 1760522478
Organization Information:Organization Name: LIFE, INC.
Practice Location:
200 LUKE ST EDENTON, NC 27932 US
Tel: 919-734-4386 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
200 LUKE ST EDENTON, NC 27932 US
Tel: 919-734-4386 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 343900000X | Transportation Services Non-emergency Medical Transport (VAN) | NC | MHL-021-013 |
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility | NC | MHL-021-013 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
MHL-021-013 | NC | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin