Life, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

MHL-007-014 Issued in NC

Legal business name

LIFE, INC.

Doing business as

LIFE, Inc./Beaufort Heights Group Home

Practice address

103 Circle St
Washington, NC 27889-9026

Phone

(252) 946-4133

Fax

(252) 974-1211

NPI assigned

Jan 22, 2007

Last updated

Dec 15, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

LIFE, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard Lynn Smith

Title

VP of Business Operations

Phone

(919) 778-1900

Specialties & licenses 1

Addresses

Other names 1

• LIFE, Inc./Beaufort Heights Group Home Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013061944. Details of each certification follow.

• CCN 34G339 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 34G339

Legal name

LIFE, INC BEAUFORT HEIGHTS GROUP HOME

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Nov 29, 1995

Last certification

Mar 3, 2026

Beds

6

Ownership / control type

Private (proprietary)

Most recent change of ownership

Mar 5, 2019

Facility address

103 Circle Street
Washington, NC 27889

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Life Inc48 organizations share this tax ID, including this one

Part of

Life Inc

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

• Life, Inc

  • Community/Behavioral Health Agency
  • New Bern, NC
  • NPI 1609004506
  NPD tax ID
• Life, Inc

  • Community/Behavioral Health Agency
  • Williamston, NC
  • NPI 1881822781
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Washington, NC
  • NPI 1023162484
  NPD tax ID
• Life, Inc.

  dba Life, Inc./Leland Day Program

  • Community/Behavioral Health Agency
  • Leland, NC
  • NPI 1023524345
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Newport, NC
  • NPI 1043364250
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Williamston, NC
  • NPI 1043364672
  NPD tax ID
• Life, Inc.

  dba The Scott House

  • Adult Care Home Facility
  • Elizabeth City, NC
  • NPI 1053451765
  NPD tax ID
• Life, Inc.

  dba Life, Inc./Cherry Lane

  • Intellectual Disabilities Intermediate Care Facility
  • New Bern, NC
  • NPI 1114071032
  NPD tax ID
• Life, Inc.

  • Adult Care Home Facility
  • Roanoke Rapids, NC
  • NPI 1134260797
  NPD tax ID
• Life, Inc.

  dba Life, Inc./Folly Street Group Home

  • Intellectual Disabilities Intermediate Care Facility
  • Supply, NC
  • NPI 1134273907
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Edenton, NC
  • NPI 1154475515
  NPD tax ID
• Life, Inc.

  dba Idlewood Group Home

  • Intellectual Disabilities Intermediate Care Facility
  • Roanoke Rapids, NC
  • NPI 1215081021
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513296000000",
    "number": "1013061944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 CAROLINA AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893369",
            "telephone_number": "252-974-2600",
            "fax_number": "252-974-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CIRCLE ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278899026",
            "telephone_number": "252-946-4133",
            "fax_number": "252-974-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFE, INC.",
        "enumeration_date": "2007-01-22",
        "last_updated": "2017-12-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "919-778-1900"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL-007-014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFE, Inc./Beaufort Heights Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Taylor Wolfe Lewis, PHARMD
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• Intellectual Disabilities Intermediate Care Facility in Washington, NC
• Providers in Washington, NC by specialty
• Intellectual Disabilities Intermediate Care Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.