Active NPI
Life, Inc.
Doing business as LIFE, Inc/Green Tee Lane
- Intellectual Disabilities Intermediate Care Facility
- Rocky Mount, NC
National Provider Identifier
1386798163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- MHL-064-020
- Legal business name
- LIFE, INC.
- Doing business as
- LIFE, Inc/Green Tee Lane
- Practice address
- 1320 Green Tee LN
Rocky Mount, NC 27804-9635 - Phone
- (252) 972-6975
- Fax
- (252) 212-0135
- NPI assigned
- Jan 22, 2007
- Organization subpart
- Yes
- Parent organization
- LIFE, INC.
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | MHL-064-020 | NC | Primary |
Addresses
Primary practice location
1320 Green Tee LN
Rocky Mount, NC 27804-9635
Mailing address
PO Box 446
Halifax, NC 27839-0446
Phone (252) 972-6975
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 944709 | Other | NC | STATE FACILITY ID |
| 340606M | Medicaid | NC |
Other names 1
- LIFE, Inc/Green Tee Lane
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 34G288
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- LIFE, INC GREEN TEE LANE
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Nov 5, 1993
- Last certification
- Dec 9, 2025
- Beds
- 6
- Ownership / control type
- Private (proprietary)
- Most recent change of ownership
- Jan 22, 2020
- Facility address
- 1320 Green Tee Lane
Rocky Mount, NC 27804
National Provider Directory
National Provider Directory- Tax ID family
- Life Inc
- Part of
- Life Inc
Other organizations with this tax ID 47
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- New Bern, NC
- NPI 1609004506
-
- Community/Behavioral Health Agency
- Williamston, NC
- NPI 1881822781
-
dba LIFE, Inc./Beaufort Heights Group Home
- Intellectual Disabilities Intermediate Care Facility
- Washington, NC
- NPI 1013061944
-
- Intellectual Disabilities Intermediate Care Facility
- Washington, NC
- NPI 1023162484
-
dba Life, Inc./Leland Day Program
- Community/Behavioral Health Agency
- Leland, NC
- NPI 1023524345
-
- Intellectual Disabilities Intermediate Care Facility
- Newport, NC
- NPI 1043364250
-
- Intellectual Disabilities Intermediate Care Facility
- Williamston, NC
- NPI 1043364672
-
dba Life, Inc./Cherry Lane
- Intellectual Disabilities Intermediate Care Facility
- New Bern, NC
- NPI 1114071032
-
- Adult Care Home Facility
- Roanoke Rapids, NC
- NPI 1134260797
-
dba Life, Inc./Folly Street Group Home
- Intellectual Disabilities Intermediate Care Facility
- Supply, NC
- NPI 1134273907
-
- Intellectual Disabilities Intermediate Care Facility
- Edenton, NC
- NPI 1154475515
NPI Registry JSON
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": "1386798163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 446",
"city": "HALIFAX",
"state": "NC",
"postal_code": "278390446",
"telephone_number": "252-972-6975",
"fax_number": "252-212-0135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 GREEN TEE LN",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278049635",
"telephone_number": "252-972-6975",
"fax_number": "252-212-0135"
}
],
"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-064-020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE FACILITY ID",
"identifier": "944709",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "340606M",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LIFE, Inc/Green Tee Lane",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Rocky Mount, NC
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.