Lifegate Residential Care

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-051-157NC Issued in NC

Legal business name

LIFEGATE RESIDENTIAL CARE

Doing business as

Lifegate Residential Care

Practice address

209 White Oak Farms Dr
Willow Spring, NC 27592-8534

Phone

(919) 639-2777

Fax

(919) 779-2955

NPI assigned

Apr 18, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cleola Mae Martin

Title

Program Manager

Phone

(919) 779-2209

Specialties & licenses 2

Addresses

Other names 1

• Lifegate Residential Care Doing business as

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1023234671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 WHITE OAK FARMS DR",
            "city": "WILLOW SPRING",
            "state": "NC",
            "postal_code": "275928534",
            "telephone_number": "919-639-2777",
            "fax_number": "919-779-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WHITE OAK FARMS DR",
            "city": "WILLOW SPRING",
            "state": "NC",
            "postal_code": "275928534",
            "telephone_number": "919-639-2777",
            "fax_number": "919-779-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGATE RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CLEOLA",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "919-779-2209",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "MHL-051-157",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-051-157NC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifegate Residential Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Willow Spring, NC
• Providers in Willow Spring, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.