Myrtle Grove Group Home
LBN: Lifetime Resources, Inc.
Myrtle Grove Group Home is an health care organization with primary practice located at 6732 Myrtle Grove Rd , Wilmington NC 28409-4804. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty.
Lifetime Resources, Inc. can be contacted via phone (910) 762-1189, or through Thacker, Jr., Robert T. via phone (910) 762-1189.
Contact Information
Primary practice address
6732 Myrtle Grove Rd
Wilmington NC 28409-4804
Phone: (910) 762-1189
Fax: (910) 762-1301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded | 315P00000X | 3406451 | North Carolina |
| Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320600000X | 3406451 | North Carolina |
Profile Details
| NPI number | 1952516700 |
|---|---|
| LBN Legal business name | Lifetime Resources, Inc. |
| DBA Doing business as | Myrtle Grove Group Home |
| Authorized official | Thacker, Jr., Robert T. PH.D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 14th, 2007 |
| Last updated | Jul 7th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952516700 | NPPES |
| North Carolina | MEDICAID | 3406451 |
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