Provider Demographics
NPI:1891839882
Name:TOTAL LIFE CARE INC
Entity Type:Organization
Organization Name:TOTAL LIFE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR-OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-776-0352
Mailing Address - Street 1:PO BOX 3106
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-3106
Mailing Address - Country:US
Mailing Address - Phone:919-776-0352
Mailing Address - Fax:919-718-1629
Practice Address - Street 1:138 S STEELE ST
Practice Address - Street 2:SUITE G
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4201
Practice Address - Country:US
Practice Address - Phone:919-776-0352
Practice Address - Fax:919-718-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2229251E00000X
NCHC2568251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600880Medicaid
NC3409471Medicaid