Provider Demographics
NPI:1720573215
Name:TOOLS4LIFE LLC
Entity Type:Organization
Organization Name:TOOLS4LIFE LLC
Other - Org Name:TOOLS4LIFE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HEDGECOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-987-6491
Mailing Address - Street 1:103 HOLLY DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-2709
Mailing Address - Country:US
Mailing Address - Phone:910-366-2946
Mailing Address - Fax:910-363-4075
Practice Address - Street 1:103 E. 8TH STREET
Practice Address - Street 2:103
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-3523
Practice Address - Country:US
Practice Address - Phone:910-987-6491
Practice Address - Fax:910-363-4075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NC261QM0801X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104503Medicaid