Life, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

LIFE, INC.

Doing business as

Wilson Dda

Practice address

505 Hemphill St
Stantonsburg, NC 27883-9011

Phone

(919) 778-1900

Fax

(919) 778-1972

NPI assigned

Feb 12, 2020

Last updated

Feb 18, 2020By 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

Richard Lynn Smith

Title

VP of Business Operations

Phone

(919) 778-1900

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• WILSON DDA Doing business as

Tax ID family

Life Inc48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

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

• Life, Inc

  • Community/Behavioral Health Agency
  • New Bern, NC
  • NPI 1609004506
  NPD tax ID
• Life, Inc

  • Community/Behavioral Health Agency
  • Williamston, NC
  • NPI 1881822781
  NPD tax ID
• Life, Inc.

  dba LIFE, Inc./Beaufort Heights Group Home

  • Intellectual Disabilities Intermediate Care Facility
  • Washington, NC
  • NPI 1013061944
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Washington, NC
  • NPI 1023162484
  NPD tax ID
• Life, Inc.

  dba Life, Inc./Leland Day Program

  • Community/Behavioral Health Agency
  • Leland, NC
  • NPI 1023524345
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Newport, NC
  • NPI 1043364250
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Williamston, NC
  • NPI 1043364672
  NPD tax ID
• Life, Inc.

  dba The Scott House

  • Adult Care Home Facility
  • Elizabeth City, NC
  • NPI 1053451765
  NPD tax ID
• Life, Inc.

  dba Life, Inc./Cherry Lane

  • Intellectual Disabilities Intermediate Care Facility
  • New Bern, NC
  • NPI 1114071032
  NPD tax ID
• Life, Inc.

  • Adult Care Home Facility
  • Roanoke Rapids, NC
  • NPI 1134260797
  NPD tax ID
• Life, Inc.

  dba Life, Inc./Folly Street Group Home

  • Intellectual Disabilities Intermediate Care Facility
  • Supply, NC
  • NPI 1134273907
  NPD tax ID
• Life, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Edenton, NC
  • NPI 1154475515
  NPD tax ID

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1700418225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 ROYALL AVE",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275348615",
            "telephone_number": "919-778-1900",
            "fax_number": "919-778-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 HEMPHILL ST",
            "city": "STANTONSBURG",
            "state": "NC",
            "postal_code": "278839011",
            "telephone_number": "919-778-1900",
            "fax_number": "919-778-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "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": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408694",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILSON DDA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Stantonsburg, NC
• Providers in Stantonsburg, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.