NPI 1003021874

Lifetime Resources, INC.

Organisation Intellectual Disabilities Intermediate Care Facility Wilmington, NC

Practice location

Address: 220 Dorchester Pl, Wilmington, NC 28412-7324
Phone: (910) 762-1189
Fax: (910) 762-1301
Mailing address: 1316 S. 16th Street, Wilmington, NC 28401-6422

Authorised official

Name: Robert T. Thacker, Jr.
Title: Executive Director
Phone: (910) 762-1189

Registered specialties (2)

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 3406452 (NC)

Other Intermediate Care Facility, Intellectual Disabilities providers in North Carolina →

Intellectual and/or Developmental Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320600000X Licence 3406452 (NC)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in North Carolina →

Registry record

NPI: 1003021874
Entity type: Organization
NPI issued: 14 May 2007
Record last updated: 7 Jul 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.