LIFESPAN, INC.


Address: 3127 Kalynne St, Charlotte, NC 28208-3125
Phone: 7043935916

LIFESPAN, INC. (NPI# 1144366790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144366790
Entity Type Organization
Organization Name LIFESPAN, INC.
Practice Address 3127 Kalynne St
Charlotte
NC 28208-3125
Mailing Address 1511 Shopton Rd
Suite A
Charlotte
NC 28217-3239
Practice Telephone 7043935916
Practice Fax Number 7043935917
Mailing Telephone 7049445100
Mailing Fax Number 7049445102
Enumeration Date 2007-01-30
Last Update Date 2016-09-30
Authorized Official Name MS. ROBIN DEVORE (VP CORPORATE COMPLIANCE/PROGRAM OPS)
Authorized Official Telephone 7049445100
Authorized Official Credential BA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 251C00000X Day Training, Developmentally Disabled Services MHL-011-217 NC Agencies
Y 251S00000X Community/Behavioral Health MHL-011-217 NC Agencies

Other Provider Identifier

State Issuer Identifier Type Code
NC 3408802 05
NC 8702247 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1962924381 Lifespan, Inc. Case Management 314 E 8th Ave, Homestead, PA 15120-1518 2017-07-07
1598950719 Lifespan, Inc. Day Training, Developmentally Disabled Services 20 Harmon Cir, Asheville, NC 28803-1318 2007-09-11
1649317850 Lifespan, Inc. Day Training, Developmentally Disabled Services 67 Redbud Ln, Waynesville, NC 28786-5640 2007-01-30
1730226945 Lifespan, Inc. Day Training, Developmentally Disabled Services 147 Iredell Ave, Troutman, NC 28166-9511 2007-01-30
1841336112 Lifespan, Inc. Day Training, Developmentally Disabled Services 5400 Tuckaseegee Rd, Charlotte, NC 28208-2522 2007-01-30
1447396098 Lifespan, Inc. Day Training, Developmentally Disabled Services 222 Hidden Forrest Ln, Hayesville, NC 28904-6502 2007-01-30
1619013695 Lifespan, Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 628 Flowe Dr, Charlotte, NC 28213-5607 2007-01-29
1285770230 Lifespan, Inc. Day Training, Developmentally Disabled Services 3747 Bon Rea Dr, Charlotte, NC 28226-3149 2007-01-29
1457400194 Lifespan, Inc. Day Training, Developmentally Disabled Services 919 Stokes St, Burlington, NC 27215-6537 2007-01-10
1003965781 Lifespan, Inc. Day Training, Developmentally Disabled Services 302 W Broad St, Statesville, NC 28677-5260 2007-01-10

Office Location

Street Address 3127 KALYNNE ST
City CHARLOTTE
State NC
Zip Code 28208-3125

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538217831 Lifespan, Inc. Day Training, Developmentally Disabled Services 3127 Kalynne St, Charlotte, NC 28208-3125 2007-01-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124645544 Charlotte Sp Senior Housing Opco, LLC Custodial Care Facility 6041 Piedmont Row Drive, Charlotte, NC 28208 2020-07-01
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1245880699 Camilla A Raley Technician 1539 Walton Rd, Charlotte, NC 28208 2019-09-18
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1699244145 Catalyst Chiropractic, Pllc Chiropractor 2620 Tuckaseegee Rd., Charlotte, NC 28208 2018-11-14
1255854691 Jessica Lynne Hunter Social Worker 2011 Water Walk Lane Apt 209, Charlotte, NC 28208 2017-07-18
1700311420 Matthew Christian Mundorf Chiropractor 2620 Tuckaseegee Rd, Charlotte, NC 28208 2017-05-01
1700235439 Erin Merchant Counselor 2016 Millerton Avenue, #2213, Charlotte, NC 28208 2016-06-03
1528432564 Monika Sheree Moore Counselor 3205 Freedom Dr, Charlotte, NC 28208 2015-11-13
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Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053925099 Essential Pathways Counseling and Consulting, Pllc Community/Behavioral Health 5009 Beatties Ford Rd Ste 107-274, Charlotte, NC 28216-2859 2020-09-08
1841809746 Ryan's Place, LLC Community/Behavioral Health 6000 Fairview Rd Ste 1259, Charlotte, NC 28210-2224 2020-07-27
1760090641 Compact Health Services LLC Community/Behavioral Health 7506 E Independence Blvd Ste 130-d, Charlotte, NC 28227-9471 2020-07-16
1366060170 Stride Community/Behavioral Health 14054 Singleleaf Lane, Charlotte, NC 28278 2020-07-08
1114540093 Curtis In Care LLC Community/Behavioral Health 10923 Chastain Parc Dr, Charlotte, NC 28216-7654 2020-05-26
1477174407 Garden of Life, Inc Community/Behavioral Health 8339 Fox Swamp Rd, Charlotte, NC 28215-9011 2020-04-30
1134753601 Luis Ariel Hernandez Community/Behavioral Health 6000 Fairview Rd # 1259, Charlotte, NC 28210-2224 2020-02-24
1205468774 Windsong Family & Psychiatric Associates, Pllc Community/Behavioral Health 416 Mccullough Dr Ste 135, Charlotte, NC 28262-4389 2020-02-12
1265071542 Counseling and Behavioral Therapy Community/Behavioral Health 16528 Silversword Dr, Charlotte, NC 28213-4876 2020-01-03
1578101283 Davis Quality Care LLC Community/Behavioral Health 11623 Sweet Rose Ct, Charlotte, NC 28269-3407 2019-12-12
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Competitor

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City CHARLOTTE
Zip Code 28208

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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