Idlewood Group Home

LBN: Life, Inc.
Idlewood Group Home is an health care organization with primary practice located at 28 Wood Glen Rd , Roanoke Rapids NC 27870-6285. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Life, Inc. can be contacted via phone (252) 537-4686, or through Smith, Richard Lynn via phone (919) 778-1900.

Contact Information

Primary practice address
28 Wood Glen Rd Roanoke Rapids NC 27870-6285
Phone: (252) 537-4686
Fax: (252) 583-1615
Website:
Map and Directions
Authorized official contact:
Name: Smith, Richard Lynn
Phone: (919) 778-1900

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X MHL-042-009 North Carolina

Profile Details

NPI number 1215081021
LBN Legal business name Life, Inc.
DBA Doing business as Idlewood Group Home
Authorized official Smith, Richard Lynn
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 22nd, 2007
Last updated Dec 15th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215081021 NPPES
North Carolina Other 922027 STATE FACILITY ID
North Carolina MEDICAID 3416196 STATE FACILITY ID

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