Provider Demographics
NPI:1528295391
Name:ONE LIFE AT A TIME, LLC
Entity type:Organization
Organization Name:ONE LIFE AT A TIME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:STERLING
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-391-2562
Mailing Address - Street 1:110 S CAMERON AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-4516
Mailing Address - Country:US
Mailing Address - Phone:336-391-2562
Mailing Address - Fax:336-725-5064
Practice Address - Street 1:1001 S MARSHALL ST
Practice Address - Street 2:SUITE 15
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-5852
Practice Address - Country:US
Practice Address - Phone:336-391-2562
Practice Address - Fax:336-725-5064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4497253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care