LIFETIME RESOURCES, INC. (NPI# 1093920878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093920878 |
| Entity Type | Organization |
| Organization Name | LIFETIME RESOURCES, INC. |
| Other Organization Name | GREENVILLE LOOP GROUP HOME |
| Practice Address |
6100 Greenville Loop Rd Wilmington NC 28409-2325 |
| Mailing Address |
1316 S. 16th Street Wilmington NC 28401-6422 |
| Practice Telephone | 9107621189 |
| Practice Fax Number | 9107621301 |
| Mailing Telephone | 9107621189 |
| Mailing Fax Number | 9107621301 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2017-07-07 |
| Authorized Official Name | DR. ROBERT T. THACKER, JR. JR. (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9107621189 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3406453 | NC | Residential Treatment Facilities |
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 3406453 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3406453 | 05 |
| Other Name | Type Code |
|---|---|
| Greenville Loop Group Home | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003021874 | Lifetime Resources, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 220 Dorchester Pl, Wilmington, NC 28412-7324 | 2007-05-14 |
| 1952516700 | Lifetime Resources, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6732 Myrtle Grove Rd, Wilmington, NC 28409-4804 | 2007-05-14 |
| 1013039833 | Lifetime Resources, Inc. | Case Management | 13091 Benedict Dr, Dillsboro, IN 47018-8480 | 2007-04-04 |
| Street Address |
6100 GREENVILLE LOOP RD |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28409-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952916728 | Emily Savannah Holland | Specialist/Technologist | 1150 King's Hwy, Wilmington, NC 28409 | 2020-09-09 |
| 1912373465 | Thomas Malenfant | Hearing Instrument Specialist | 474 New Centre Drive, #6, Wilmington, NC 28409 | 2015-08-19 |
| 1720482862 | Leslie Morton Garris | Pharmacist | 6013 Chancellorville Drive, Wilmington, NC 28409 | 2014-10-17 |
| 1659621720 | Charles Warren Moorehead | Social Worker | 5710 Oleander Dr. Suite 208, Wilmington, NC 28409 | 2012-09-14 |
| 1992972020 | Nancy Beth Kotz | Social Worker | 6211 Terrapin Ct, Wilmington, NC 28409 | 2008-05-08 |
| 1366611089 | Michael Royce Penland | Psychologist | 5002-1 Hewletts Run, Wilmington, NC 28409 | 2008-02-27 |
| 1184755092 | Keith W Mann | Dentist | 818-101 Pine Grove Drive, Wilmington, NC 28409 | 2007-03-09 |
| 1477650554 | Jeffrey Beecham Chick | Specialist | 1201 Porches Dr, Suite 2, Wilmington, NC 28409 | 2006-09-20 |
| 1407964067 | Richard A. Lally | Counselor | 5425 Golden Eagle Court, Wilmington, NC 28409 | 2006-08-25 |
| 1598290520 | Monaca Lachman | Counselor | 6020 Leeward Ln, Wilmington, NC 28409-0129 | 2017-04-27 |
| Find all providers in zip 28409 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053657973 | Robin Hood Group Home | Intermediate Care Facility, Mentally Retarded | 1507 Robinhood Rd, Wilmington, NC 28401-6623 | 2012-12-20 |
| 1336293794 | Life, Inc. | Intermediate Care Facility, Mentally Retarded | 105 Cherokee Trl, Wilmington, NC 28409-3407 | 2007-01-23 |
| 1598847550 | Cape Fear Group Homes, Inc. | Intermediate Care Facility, Mentally Retarded | 1519 Robert E Lee Dr, Wilmington, NC 28412-7180 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702937 | Gha Autism Supports | Intermediate Care Facility, Mentally Retarded | 44012 Morrow Mountain Rd, Albemarle, NC 28001-8616 | 2020-05-21 |
| 1811517774 | Educare Community Living Corporation-north Carolina | Intermediate Care Facility, Mentally Retarded | 834 Tyvola Rd Ste 116, Charlotte, NC 28217-3542 | 2020-04-21 |
| 1598125460 | Rha Health Services Nc LLC | Intermediate Care Facility, Mentally Retarded | 410 N Mineral Springs Rd, Durham, NC 27703-3618 | 2016-03-04 |
| 1023478294 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 619 Ray Ave, Hendersonville, NC 28792-2668 | 2016-03-02 |
| 1740649417 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 310 Locust Street, West Jefferson, NC 28694 | 2016-02-23 |
| 1841655453 | Journeys Healthcare | Intermediate Care Facility, Mentally Retarded | 515 Carver Moore Rd, Lake Waccamaw, NC 28450-9713 | 2015-12-24 |
| 1326414665 | Rha North Carolina Mr, Inc. | Intermediate Care Facility, Mentally Retarded | 1388 Lewis Fork Baptist Ch Rd, Ferguson, NC 28624-9080 | 2015-08-20 |
| 1609299916 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 1802 Strickland Bridge Rd, Fayetteville, NC 28304-5739 | 2014-01-23 |
| 1861822314 | Voca Corporation of North Carolina | Intermediate Care Facility, Mentally Retarded | 4109 Enoch Dr, Charlotte, NC 28269-2578 | 2013-11-20 |
| 1902144314 | Rouse's Group Home Inc | Intermediate Care Facility, Mentally Retarded | 5820 Nc 135, Stoneville, NC 27048-8478 | 2013-01-18 |
| Find all providers with the same taxonomy | ||||
| City | WILMINGTON |
| Zip Code | 28409 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.