NPIMap

Organization Active NPI

Lifequest Disabilities Services, Inc

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, NC
National Provider Identifier
1942537428
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
LIFEQUEST DISABILITIES SERVICES, INC
Practice address
231 New Bridge St
Jacksonville, NC 28540-4736
Phone
(910) 430-4152
Fax
(910) 430-4310
NPI assigned
Nov 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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) 389-0901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

231 New Bridge St
Jacksonville, NC 28540-4736

Mailing address

325 Bannermans Mill Rd
Richlands, NC 28574-8105
Phone (910) 389-0901

Other identifiers 1

IdentifierTypeStateIssuer
3418747MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Lifequest Disabilities Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1942537428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 BANNERMANS MILL RD",
            "city": "RICHLANDS",
            "state": "NC",
            "postal_code": "285748105",
            "telephone_number": "910-389-0901",
            "fax_number": "910-430-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 NEW BRIDGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404736",
            "telephone_number": "910-430-4152",
            "fax_number": "910-430-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEQUEST DISABILITIES SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2014-08-06",
        "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": "910-389-0901",
        "authorized_official_credential": "BA/QP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418747",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.