LIFESPAN, INC. (NPI# 1326197062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326197062 |
| Entity Type | Organization |
| Organization Name | LIFESPAN, INC. |
| Practice Address |
130 Williamson Ave Mount Airy NC 27030-5156 |
| Mailing Address |
200 Clanton Rd Charlotte NC 28217-1304 |
| Practice Telephone | 3367830829 |
| Practice Fax Number | 3367834754 |
| Mailing Telephone | 7049445100 |
| Mailing Fax Number | 7049445102 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2013-06-03 |
| Authorized Official Name | MS. DAVAN CLONINGER (CEO/PRESIDENT) |
| Authorized Official Telephone | 7049445100 |
| Authorized Official Credential | BA, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | 86000192 | NC | Agencies |
| 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 |
| 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 |
| Street Address |
130 WILLIAMSON AVE |
| City | MOUNT AIRY |
| State | NC |
| Zip Code | 27030-5156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437618626 | Vivian Whitlock France | Counselor | 130 Williamson Ave, Mount Airy, NC 27030-5156 | 2019-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
| 1376984880 | Shari York | Counselor | 847 Westlake Dr, Mount Airy, NC 27030 | 2013-07-12 |
| 1861745069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 1305 Park Dr, Mount Airy, NC 27030 | 2012-10-25 |
| 1346592169 | Debra Lynn Campbell | Physician Assistant | 709 West Independence Blvd., Mount Airy, NC 27030 | 2012-10-03 |
| 1720217680 | Lena Anderson Ferris | Nurse Practitioner | 708 S South St Ste 400, Mount Airy, NC 27030 | 2009-07-13 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| 1336261528 | Thomas R Jackson Dds Pa | Dentist | 1007 Rockford Street, Mount Airy, NC 27030 | 2007-04-06 |
| 1467585422 | Ridgecrest Ritirement Community | Assisted Living Facility | Ridgecrest Retirement, LLC, 1000 Ridgecrest Ln., Mount Airy, NC 27030 | 2007-03-13 |
| 1568516755 | Lou Urmos | Family Medicine | 805 Merita Street, Mt Airy, NC 27030 | 2007-01-23 |
| 1568516391 | Mark Lee Appler | Internal Medicine | 708 S South St Ste 100, Mount Airy, NC 27030 | 2007-01-22 |
| Find all providers in zip 27030 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568060572 | Stand By Me Mhs L.l.s | Day Training, Developmentally Disabled Services | 3221 Loftyview Dr, High Point, NC 27260-2617 | 2020-10-12 |
| 1811508427 | Brian S Coleman | Day Training, Developmentally Disabled Services | 3205 Midvale Dr Apt 107, Wilmington, NC 28412-3800 | 2020-08-17 |
| 1841801255 | Nicholas Mcarthur Bennett | Day Training, Developmentally Disabled Services | 302 C, Greenville, NC 27834 | 2020-08-11 |
| 1922626357 | Tomesha Chimere' Flow | Day Training, Developmentally Disabled Services | 1204 Hadel Pl, Knightdale, NC 27545-7513 | 2020-07-13 |
| 1710500616 | New Horizon Residential Services L.l.c | Day Training, Developmentally Disabled Services | 11120 Carver Pond Rd, Charlotte, NC 28269-5007 | 2020-05-26 |
| 1366064479 | Evolving Hands Health Care Services | Day Training, Developmentally Disabled Services | 1099 Barrett Cabin Rd, Murfreesboro, NC 27855-9380 | 2020-05-12 |
| 1730718776 | Dedicated Caregivers LLC | Day Training, Developmentally Disabled Services | 2750 E W T Harris Blvd Ste 218, Charlotte, NC 28213-4367 | 2020-04-02 |
| 1417593005 | Ehomecare | Day Training, Developmentally Disabled Services | 18 Palaside Dr Ne, Concord, NC 28025-3026 | 2019-11-19 |
| 1972149565 | All Care | Day Training, Developmentally Disabled Services | 416 Old Charlotte Rd Sw, Concord, NC 28027-6314 | 2019-11-19 |
| 1891356267 | Onas Place | Day Training, Developmentally Disabled Services | 115 W Court St Ste A, Rutherfordton, NC 28139-2820 | 2019-06-25 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT AIRY |
| Zip Code | 27030 |
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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.