Positive Life Styles

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL098033 Issued in NC

Legal business name

POSITIVE LIFE STYLES

Practice address

4805 Green Wing Rd
Wilson, NC 27893-8142

Phone

(252) 281-3967

Fax

(252) 674-7060

NPI assigned

Nov 14, 2016

Organization subpart

No

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

Authorized official

Name

Iris H ReidNPI 1851840516

Title

Owner

Phone

(252) 281-3967

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Iris Reid

  • Adult Care Home Facility
  • Wilson, NC
  • NPI 1851840516
  NPD Authorized official

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1013459643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 GREEN WING RD",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938142",
            "telephone_number": "252-281-3967",
            "fax_number": "252-674-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 GREEN WING RD",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938142",
            "telephone_number": "252-281-3967",
            "fax_number": "252-674-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE LIFE STYLES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "IRIS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-281-3967"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL098033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER LICENSE",
            "identifier": "FCL098033",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Polley Clinic of Dermatology & Dermatologic Surgery
• Dennis Polley, D.O.
• Elizabeth Pollock, MS, LCMHCA
• Alice Hall Pope
• Port Human Services
• Betty J Powell, CFTS
• Christina Gurley Poythress, PA-C
• Rolando Andre Prado, D.D.S., M.S.
• Sunil K Prakash Chand, M.D
• Precious Cargo Services LLC

• Adult Care Home Facility in Wilson, NC
• Providers in Wilson, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.