LIFESPAN INC (NPI# 1245776533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245776533 |
| Entity Type | Organization |
| Organization Name | LIFESPAN INC |
| Practice Address |
6123 Woodthrush Dr Charlotte NC 28227-1027 |
| Mailing Address |
1511 Shopton Rd Suite A Charlotte NC 28217-3239 |
| Practice Telephone | 7045316857 |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |
| Authorized Official Name | ROBIN DEVORE (VP CORPORATE COMPLIANCE AND PROGRAM) |
| Authorized Official Telephone | 7047631887 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MHL-060-1331 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3408802 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700323094 | Lifespan Inc | Community/Behavioral Health | 7533 Farm Gate Dr, Charlotte, NC 28215-3659 | 2017-01-24 |
| 1295272672 | Lifespan Inc | Community/Behavioral Health | 6716 Woodthrush Dr, Charlotte, NC 28227-1059 | 2017-01-24 |
| 1467999763 | Lifespan Inc | Community/Behavioral Health | 7609 Linda Lake Dr, Charlotte, NC 28215-2825 | 2017-01-24 |
| 1902342173 | Lifespan Inc | Community/Behavioral Health | 5009 Banfshire Rd, Charlotte, NC 28215-2066 | 2017-01-12 |
| 1477099752 | Lifespan Inc | Community/Behavioral Health | 4806 Farm Pond Ln, Charlotte, NC 28212-8558 | 2017-01-11 |
| 1548890346 | Lifespan Inc | Community/Behavioral Health | 1669 Hendrix Rd, Murphy, NC 28906-3664 | 2020-01-21 |
| 1043858590 | Lifespan Inc | Community/Behavioral Health | 5 Oak St, Asheville, NC 28801-3003 | 2019-12-16 |
| 1659912806 | Lifespan Inc | Community/Behavioral Health | 5 Oak St, Asheville, NC 28801-3003 | 2019-09-30 |
| 1942745005 | Lifespan Inc | Community/Behavioral Health | 31 James St, Brevard, NC 28712-3779 | 2016-12-28 |
| 1538603881 | Lifespan Inc | Community/Behavioral Health | 318 Primrose Ln, Hendersonville, NC 28739-4686 | 2016-12-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LIFESPAN INCORPORATED | 1511 Shopton Rd Ste A, Charlotte, NC 28217-3240 |
| Street Address |
6123 WOODTHRUSH DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28227-1027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396693 | Phyllis Newsome Wilson | Technician | 8423 Empress Ct, Charlotte, NC 28227 | 2019-09-27 |
| 1134611239 | Alyssa Latonia Rodgers | Counselor | 7512 Spring Spruce Ln, Charlotte, NC 28227 | 2018-06-04 |
| 1114463429 | Andrea Henneberry | Physical Therapy Assistant | 9706 Stoney Glen Dr Apt L, Mint Hill, NC 28227 | 2017-01-10 |
| 1649726589 | Keba Bosley | Social Worker | 5912 Brightstar Valley Road, Mint Hill, NC 28227 | 2016-08-31 |
| 1710330071 | Carolina Family Services | Community/Behavioral Health | 5737 Old Magnolia Lane, Mint Hill, NC 28227 | 2016-07-21 |
| 1518311901 | Aynsley Girardeau | Optometrist | 7014 Tutor Street, Suite C, Mint Hill, NC 28227 | 2016-04-21 |
| 1487037875 | Shalini Kamodia | Dentist | 11300 Cresthill Dr Ste 105, Mint Hill, NC 28227 | 2015-07-02 |
| 1629455720 | Yes We Care Human Services of Mecklenburg County | Adult Companion | 8201 Willowlake Ct, Charlotte, NC 28227 | 2015-04-28 |
| 1841677077 | Hewitt Home Care | Psychiatric Residential Treatment Facility | 2331 Crownpoint Executive Drive, Charlotte, NC 28227 | 2015-04-27 |
| 1467847426 | Marguerita Sitrin Blaker | Psychologist | 2400 Crownpoint Executive Drive, Suite 100, Office #5, Charlotte, NC 28227 | 2015-04-06 |
| Find all providers in zip 28227 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| 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] |
| 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 |
| Find all providers in CHARLOTTE | ||||
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| 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.