LIFE, INC/GREEN TEE LANE
NPI 1386798163
Intermediate Care Facility, Intellectual Disabilities in Rocky Mount, NC
NPI Status: Active since January 22, 2007
Contact Information
1320 GREEN TEE LN
ROCKY MOUNT, NC
ZIP 27804
Phone: (252) 972-6975
Fax: (252) 212-0135
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 34D0994169
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 12-05-2027
About LIFE, INC/GREEN TEE LANE
This page provides the complete NPI Profile along with additional information for Life, Inc/green Tee Lane, a provider established in Rocky Mount, North Carolina operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1386798163 assigned on January 2007. The practitioner's primary taxonomy code is 315P00000X with license number MHL-064-020 (NC). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Life, Inc/green Tee Lane. The authorized official of this NPI record is Richard Lynn Smith (Vp Of Business Operations)
- NPI
- 1386798163
- Provider Legal Name
- LIFE, INC.
- Other Organization Name
- LIFE, INC/GREEN TEE LANE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1320 GREEN TEE LN ROCKY MOUNT, NC 27804
- Location Phone
- (252) 972-6975
- Location Fax
- (252) 212-0135
- Mailing Address
- PO BOX 446 HALIFAX, NC 27839
- Mailing Phone
- (252) 972-6975
- Mailing Fax
- (252) 212-0135
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 01-22-2007
- Last Update Date
- 12-15-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- MHL-064-020
- License State
- NC
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 944709 | OTHER (01) | NC | STATE FACILITY ID |
| 340606M | MEDICAID (05) | NC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D0994169
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- December 06, 2025
- Certificate Expiration Date
- December 05, 2027
- Laboratory Director
- SANDRA DUKE RN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Life, Inc/green Tee Lane to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1386798163, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386798163, enumerated as an "organization" on January 22, 2007.
The provider is located at 1320 GREEN TEE LN ROCKY MOUNT, NC 27804 and the phone number is (252) 972-6975.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
