Active NPI
Lifequest Disabilities Services, Inc.
- Developmentally Disabled Services Day Training Agency
- Jacksonville, NC
National Provider Identifier
1063849693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- LIFEQUEST DISABILITIES SERVICES, INC.
- Practice address
- 603 New Bridge St
Jacksonville, NC 28540-5432 - Phone
- (910) 430-4152
- Fax
- (910) 431-4153
- NPI assigned
- Sep 27, 2013
- Last updated
- Sep 27, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jane B Williams, BA/QP
- Title
- President
- Phone
- (910) 430-4152
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | NU | Primary |
Addresses
Primary practice location
603 New Bridge St
Jacksonville, NC 28540-5432
Mailing address
199 Country Club Blvd
Jacksonville, NC 28540-9376
Phone (910) 430-4152
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 516035 | Other | NC | TRICARE NORTH |
National Provider Directory
National Provider Directory- Tax ID family
- Lifequest Disabilities Services Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Jacksonville, NC
- NPI 1851691117
-
- Developmentally Disabled Services Day Training Agency
- Jacksonville, NC
- NPI 1942537428
Locations
199 Country Club Blvd
Jacksonville, NC 28540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380240000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1380240000000",
"number": "1063849693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 COUNTRY CLUB BLVD",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285409376",
"telephone_number": "910-430-4152",
"fax_number": "910-430-4153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 NEW BRIDGE ST",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285405432",
"telephone_number": "910-430-4152",
"fax_number": "910-431-4153"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFEQUEST DISABILITIES SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-09-27",
"last_updated": "2013-09-27",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "JANE",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "910-430-4152",
"authorized_official_credential": "BA/QP"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE NORTH",
"identifier": "516035",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
- Liberty Nursing Services, LLC (Liberty Nursing Services)
- Janelle Libretto, CCC-SLP
- Erik James Lickteig, PA
- Lifequest Disabilities Services
- Lifequest Disabilities Services, Inc
- Light to My Path Therapeutic Services Inc.
- Lighthouse Counseling, Inc.
- Elwood Glenn Likens, O.D
- Liminal Healing PLLC
- Diana Chun Lin, L.AC., DAOM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.