OrganizationActive
Life, Inc.
NPI 1437203890 · Intellectual Disabilities Intermediate Care Facility · Wilson, NC
Provider details
- NPI number
- 1437203890
- 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-098-011 (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
4105 Raven Ridge Dr Nw
Wilson, NC 27896-9656
Phone: (252) 291-8348
Fax: (252) 291-0812
Street-level locationGet directions
Mailing address
2609 Royall Ave
Goldsboro, NC 27534-8615
Other names (DBA / former)
- Doing business as
- Life/Raven Ridge Group Home
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.