Lifespan Inc
Organization Active NPI Community/Behavioral Health Agency · Charlotte, NC
NPI 1477099752 · NPPES record last updated Jan 11, 2017
Key facts
- NPI
- 1477099752
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- MHL-060-1336 (NC)
- Legal business name
- LIFESPAN INC
- Practice address
- 4806 Farm Pond LN
Charlotte, NC 28212-8558 - Phone
- (704) 536-7739
- NPI assigned
- Jan 11, 2017
- Organization subpart
- No
Authorized official
- Name
- Robin Devore
- Title
- VP Corporate Compliance and Program
- 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 |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | MHL-060-1336 | NC | Yes |
Addresses
Primary practice location
4806 Farm Pond LN
Charlotte, NC 28212-8558
Mailing address
1511 Shopton Rd
Suite a
Charlotte, NC 28217-3239
Phone (704) 944-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3408802 | Medicaid | NC |
Other providers in Charlotte, NC
- Lifeskills Counseling & Consulting Group
- Lifeskills Counseling & Consulting Group, PLLC
- Lifespan Inc
- Lifespan Inc
- Lifespan Inc
- Lifespan Inc
- Lifespan Inc
- Lifespan Incorporated
- Lifespan, Inc
- Lifespan, Inc.
All providers in Charlotte, 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 Jan 11, 2017. 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.