LIFESPAN, INC. (NPI# 1285770230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285770230 |
| Entity Type | Organization |
| Organization Name | LIFESPAN, INC. |
| Practice Address |
3747 Bon Rea Dr Charlotte NC 28226-3149 |
| Mailing Address |
1511 Shopton Rd Suite A Charlotte NC 28217-3239 |
| Practice Telephone | 7045417334 |
| Practice Fax Number | 7049445102 |
| Mailing Telephone | 7049445100 |
| Mailing Fax Number | 7049445102 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2018-11-05 |
| Authorized Official Name | MS. ROBIN DEVORE (VP CORPORATE COMPLIANCE/PROGRAM OPS) |
| Authorized Official Telephone | 7049445100 |
| Authorized Official Credential | BA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | MHL-060-120 | NC | Agencies |
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-060-120 | NC | Residential Treatment Facilities |
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3408802 | 05 |
| 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 |
| 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 |
| 1326197062 | Lifespan, Inc. | Day Training, Developmentally Disabled Services | 130 Williamson Ave, Mount Airy, NC 27030-5156 | 2007-01-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | LIFESPAN, INC. | 800 Bell Trace Circle, Bloomington, IN 47408 |
| Street Address |
3747 BON REA DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226-3149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
| Find all providers in zip 28226 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811517774 | Educare Community Living Corporation-north Carolina | Intermediate Care Facility, Mentally Retarded | 834 Tyvola Rd Ste 116, Charlotte, NC 28217-3542 | 2020-04-21 |
| 1861822314 | Voca Corporation of North Carolina | Intermediate Care Facility, Mentally Retarded | 4109 Enoch Dr, Charlotte, NC 28269-2578 | 2013-11-20 |
| 1770827552 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 8205 Browne Rd., Charlotte, NC 28217 | 2012-11-19 |
| 1063764702 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 5917 Rowan Way, Charlotte, NC 28214 | 2012-10-04 |
| 1972854693 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 4319 Mantle Ct, Charlotte, NC 28205-7243 | 2012-09-20 |
| 1093066714 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 4400 Dalmoor Dr, Charlotte, NC 28212-2157 | 2012-09-20 |
| 1043561764 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 1123 Ravendale Dr, Charlotte, NC 28216-1526 | 2012-09-20 |
| 1255451233 | Voca Corporation of North Carolina, Inc. | Intermediate Care Facility, Mentally Retarded | 5416 Oak Dr, Charlotte, NC 28216-2645 | 2007-03-31 |
| 1972623957 | Voca Corporation of North Carolina, Inc. | Intermediate Care Facility, Mentally Retarded | 1615 Purser Dr, Charlotte, NC 28215-2934 | 2007-03-31 |
| 1598885584 | Voca Corporation of North Carolina, Inc. | Intermediate Care Facility, Mentally Retarded | 2103 Wilson Ave, Charlotte, NC 28208-4655 | 2007-03-31 |
| 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.