| Leisure Home Life, Inc. | |
|
800 E Saint John St Tarboro NC 27886-4544 | |
| (252) 641-4107 | |
| (252) 973-8599 |
| Full Name | Leisure Home Life, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 800 E Saint John St, Tarboro, North Carolina |
| Authorized Official Name and Position | Tempsie Davis Richardson (ADMINISTRATOR) |
| Authorized Official Contact | 2526414107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leisure Home Life, Inc. Po Box 2087 Rocky Mount NC 27802-2087 Ph: (252) 641-4107 | Leisure Home Life, Inc. 800 E Saint John St Tarboro NC 27886-4544 Ph: (252) 641-4107 |
| NPI Number | 1225246572 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225246572 | NPI | - | NPPES |
| 780233 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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