OrganizationActive
Life, Inc.
NPI 1679627350 · Intellectual Disabilities Intermediate Care Facility · Wilson, NC
Provider details
- NPI number
- 1679627350
- 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-098-012 (NC)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
5910 Farmwood Loop
Wilson, NC 27896-8007
Phone: (252) 291-9647
Fax: (252) 291-0812
Approximate (ZIP-level) locationGet directions
Mailing address
2609 Royall Ave
Goldsboro, NC 27534-8615
Other names (DBA / former)
- Doing business as
- Mckeel Loop Road Home
Registry dates
- Enumerated
- 2007-01-22
- 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.