Lifespan
Organization Active NPI Community/Behavioral Health Agency · Andrews, NC
NPI 1376927236 · NPPES record last updated Sep 7, 2016
Key facts
- NPI
- 1376927236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- MHL-020-068 (NC)
- Legal business name
- LIFESPAN
- Practice address
- 291 Stewart Rd
Andrews, NC 28901-8603 - Phone
- (828) 321-6034
- NPI assigned
- Jul 10, 2015
- Organization subpart
- No
Authorized official
- Name
- Robin Devore, BA
- Title
- VP Corporate Compliance/Program Ops
- Phone
- (704) 944-5100
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Lifespan Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | MHL-020-068 | NC | |
| Community/Behavioral Health Agency | 251S00000X | MHL-020-068 | NC | Yes |
Addresses
Primary practice location
291 Stewart Rd
Andrews, NC 28901-8603
Mailing address
1511 Shopton Rd
Suite a
Charlotte, NC 28217-3239
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3408802 | Medicaid | NC |
Other providers in Andrews, NC
- Dionne Julia Joseph
- Kerr Drug Inc
- Paul Judson Kinsland IV
- L and N Family Care Home Inc
- Brenda G Libman
- Lifespan Incorporated
- Cassandra Lindley
- Stephanie Loy
- Kenneth Bret Marasco
- Joseph D Mariano
All providers in Andrews, NC · Community/Behavioral Health Agency in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.