Provider Demographics
NPI:1699838706
Name:THE SIMPLE LIFE SERVICES, INC.
Entity Type:Organization
Organization Name:THE SIMPLE LIFE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-868-8328
Mailing Address - Street 1:156 VANDIVER DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-0911
Mailing Address - Country:US
Mailing Address - Phone:704-524-9323
Mailing Address - Fax:770-618-3068
Practice Address - Street 1:1224 N. FLINT STREET
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-5239
Practice Address - Country:US
Practice Address - Phone:704-524-9323
Practice Address - Fax:770-618-3068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300821BMedicaid
NC8300821Medicaid
NC8300821GMedicaid
NC6006972Medicaid
NC8702129Medicaid
NC8300821HMedicaid
NC3418076Medicaid