NPIMap

Organization Active NPI

Living Well Centre

  • Community/Behavioral Health Agency
  • Durham, NC
National Provider Identifier
1053475780
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIVING WELL CENTRE
Practice address
1804 MLK Jr. Parkway
Suite 210
Durham, NC 27707-3587
Phone
(919) 489-2254
Fax
(919) 403-1551
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Delice Coffey, MA
Title
Ceo
Phone
(919) 489-2254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1804 MLK Jr. Parkway
Suite 210
Durham, NC 27707-3587

Mailing address

1804 MLK Jr. Parkway
Suite 210
Durham, NC 27707-3587
Phone (919) 489-2254

Other identifiers 1

IdentifierTypeStateIssuer
8300257MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Living Well Centre4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053475780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 MLK JR. PARKWAY",
            "address_2": "SUITE 210",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073587",
            "telephone_number": "919-489-2254",
            "fax_number": "919-403-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 MLK JR. PARKWAY",
            "address_2": "SUITE 210",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073587",
            "telephone_number": "919-489-2254",
            "fax_number": "919-403-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COFFEY",
        "authorized_official_first_name": "DELICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-489-2254",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300257",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.