OrganizationActive
Life, Inc.
NPI 1316091770 · Intellectual Disabilities Intermediate Care Facility · Chocowinity, NC
Provider details
- NPI number
- 1316091770
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Life, Inc.
- Organization subpart
- Yes
- Authorized official
- Richard Smith, Vp of Business Operations(919) 778-1900
- License
- MHL-007-006 (NC)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
77 Edgewood Dr
Chocowinity, NC 27817-8286
Phone: (252) 975-6468
Fax: (252) 974-1211
Street-level locationGet directions
Mailing address
Po Box 1507
Washington, NC 27889-1507
Registry dates
- Enumerated
- 2007-01-23
- Last updated
- 2017-12-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.