Active NPI
Life Based Conceptions, LLC
- Community/Behavioral Health Agency
- Durham, NC
National Provider Identifier
1457540700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- LIFE BASED CONCEPTIONS, LLC
- Practice address
- 2144 Page Rd
Suite 102
Durham, NC 27703-5952 - Phone
- (919) 403-6160
- Fax
- (919) 640-8810
- NPI assigned
- Oct 22, 2007
- 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
- Mr. Reginald Giles Carter, QMHP
- Title
- Community Support Professional
- Phone
- (919) 403-6160
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | NC | ||
| Community/Behavioral Health Agency | 251S00000X | NC | Primary |
Addresses
Primary practice location
2144 Page Rd
Suite 102
Durham, NC 27703-5952
Mailing address
2144 Page Road, Ste 102
Durham, NC 27703-2564
Phone (919) 403-6160
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8302408 | Medicaid | NC | |
| 3418491 | Medicaid | NC |
Other names 1
- LBC
National Provider Directory
National Provider Directory- Tax ID family
- LBC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Developmentally Disabled Services Day Training Agency
- Durham, NC
- NPI 1831364306
Locations
2144 Page Rd
Ste 102
Durham, NC 27703
Phone (919) 403-6160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193011200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1377043200000",
"number": "1457540700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2144 PAGE ROAD, STE 102",
"city": "DURHAM",
"state": "NC",
"postal_code": "277032564",
"telephone_number": "919-403-6160",
"fax_number": "919-640-8810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2144 PAGE RD",
"address_2": "SUITE 102",
"city": "DURHAM",
"state": "NC",
"postal_code": "277035952",
"telephone_number": "919-403-6160",
"fax_number": "919-640-8810"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE BASED CONCEPTIONS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-22",
"last_updated": "2013-08-21",
"status": "A",
"authorized_official_last_name": "CARTER",
"authorized_official_first_name": "REGINALD",
"authorized_official_middle_name": "GILES",
"authorized_official_title_or_position": "COMMUNITY SUPPORT PROFESSIONAL",
"authorized_official_telephone_number": "919-403-6160",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "QMHP"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8302408",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3418491",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LBC",
"code": "3",
"type": "Doing Business As"
}
]
}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 21, 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.