Lifespan, Inc.

Organization Active NPI Developmentally Disabled Services Day Training Agency · Waynesville, NC

NPI 1497940613 · NPPES record last updated Jun 3, 2013

Key facts

NPI
1497940613
Entity type
Organization (NPI type 2)
Primary specialty
Developmentally Disabled Services Day Training Agency 251C00000X
License
MHL-044-041 (NC)
Legal business name
LIFESPAN, INC.
Practice address
627 N Main St
Suite 1
Waynesville, NC 28786-3819
Phone
(828) 452-1720
Fax
(828) 452-1721
NPI assigned
Sep 11, 2007
Organization subpart
No

Authorized official

Name
Ms. Davan Cloninger, BA, MA
Title
Ceo/President
Phone
(704) 944-5100

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Lifespan Inc (58 organizations share this tax ID)

Locations

627 N Main St
#1
Waynesville, NC 28786
Phone (828) 452-1720

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X MHL-044-041 NC Yes

Addresses

Primary practice location

627 N Main St
Suite 1
Waynesville, NC 28786-3819

Mailing address

200 Clanton Rd
Charlotte, NC 28217-1304
Phone (704) 944-5100

Other identifiers

IdentifierTypeStateIssuer
8300695BMedicaidNC

Other providers in Waynesville, NC

All providers in Waynesville, NC · Developmentally Disabled Services Day Training Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.