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MYRTLE GROVE GROUP HOME
NPI 1952516700
Intermediate Care Facility, Intellectual Disabilities in Wilmington, NC

Active since May 14, 2007
6732 MYRTLE GROVE RD, WILMINGTON, NC 28409(910) 762-1189(910) 762-1301 Get Directions Write a Review

NPPES record last updated: July 7, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Myrtle Grove Group Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYRTLE GROVE GROUP HOME (NPI 1952516700) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Wilmington, North Carolina and active in the NPI registry since May 2007. The organization lists Robert T. Thacker, Jr., Executive Director, as its authorized official.

NPPES Registry Identity

NPI1952516700
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameLIFETIME RESOURCES, INC.
Location Address6732 MYRTLE GROVE RDWilmington, NC 28409-4804
Mailing Address1316 S. 16th StreetWilmington, NC 28401-6422 · (910) 762-1189 · Fax (910) 762-1301
Phone(910) 762-1189
Fax(910) 762-1301
Organization SubpartNo
Authorized OfficialRobert T. Thacker, Jr.Executive Director · (910) 762-1189
Enumeration DateMay 14, 2007
Last NPPES UpdateJuly 7, 2017
✔ NPI 1952516700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in NC · 3406451
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X · License 3406451 (NC)
6732 MYRTLE GROVE RD, Wilmington, NC 28409
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Other Names 1

Other NameMyrtle Grove Group Home

Other Identifiers 1

Medicaid3406451NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifetime Resources, Inc.'s NPI number?

The NPI number for Lifetime Resources, Inc. is 1952516700. It was assigned to this organization in the NPPES registry on May 14, 2007. The provider is also known as Myrtle Grove Group Home.

Where is Lifetime Resources, Inc. located?

Lifetime Resources, Inc. is located at 6732 Myrtle Grove Rd, Wilmington, NC 28409. The listed phone number is (910) 762-1189.

What is Lifetime Resources, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Lifetime Resources, Inc. was last updated on July 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.