LIFESPAN, INC. (NPI# 1730226945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730226945 |
| Entity Type | Organization |
| Organization Name | LIFESPAN, INC. |
| Practice Address |
147 Iredell Ave Troutman NC 28166-9511 |
| Mailing Address |
1511 Shopton Rd Suite A Charlotte NC 28217-3239 |
| Practice Telephone | 7048721321 |
| Practice Fax Number | 7048729515 |
| Mailing Telephone | 7049445100 |
| Mailing Fax Number | 7049445102 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-09-06 |
| 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 | K-49502 | NC | Agencies |
| Y | 251S00000X | Community/Behavioral Health | K-49502 | 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 |
| 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 |
| 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 |
147 IREDELL AVE |
| City | TROUTMAN |
| State | NC |
| Zip Code | 28166-9511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156063 | Ebony N Wilson | Social Worker | 183 Iredell Ave, Troutman, NC 28166 | 2019-10-22 |
| 1588213573 | Kendall Troutman | Speech-Language Pathologist | 130 Oswalt Amity Rd, Troutman, NC 28166 | 2019-09-11 |
| 1487089561 | Stuart Elliott Tolman | Pharmacist | 408 Stillwater Lane, Troutman, NC 28166 | 2013-09-09 |
| 1558390476 | Troutman 1st Rx Pharmacy | Pharmacy | 106 Wagner Street, Troutman, NC 28166 | 2006-07-02 |
| 1114917309 | Lake Norman Medical Equipment | Durable Medical Equipment & Medical Supplies | 693 N Main St, Troutman, NC 28166 | 2005-10-27 |
| 1518457886 | Lauren Brannon | Registered Nurse | 154 S Main St, Troutman, NC 28166 | 2018-05-12 |
| 1568972123 | Denton Mow | Physician Assistant | 154 S Main St, Troutman, NC 28166 | 2017-10-09 |
| 1184659682 | Angelita C. Le Cras, Dds, Pa | Dentist | 204 South Main Street, Troutman, NC 28166 | 2006-07-12 |
| 1851326359 | Angelita Cleofe Lecras | Dentist | 204 South Main Street, Troutman, NC 28166 | 2006-07-12 |
| 1760955314 | Piedmont Healthcare, Pa | Family Medicine | 154 S Main St, Troutman, NC 28166-0200 | 2019-01-07 |
| Find all providers in zip 28166 | ||||
| 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 |
|---|---|---|---|---|
| 1912394818 | Shane Sarley | Community/Behavioral Health | 107 Deer Cove Ln, Troutman, NC 28166-8812 | 2015-04-20 |
| 1861090706 | Miracle Houses, Inc. | Community/Behavioral Health | 320 Winchester Rd, Troutman, NC 28166-9644 | 2020-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121438 | Curtis Wayne Royal | Community/Behavioral Health | 1407 Groveland Trl, Greensboro, NC 27407-5061 | 2020-10-09 |
| 1578178588 | Emmanuel Homecare, Inc. | Community/Behavioral Health | 12551 Hashanli Pl, Matthews, NC 28105-3401 | 2020-09-15 |
| 1336753284 | Transformation Health Services Inc. | Community/Behavioral Health | 2023 Connonade Dr, Waxhaw, NC 28173-0109 | 2020-09-08 |
| 1053925099 | Essential Pathways Counseling and Consulting, Pllc | Community/Behavioral Health | 5009 Beatties Ford Rd Ste 107-274, Charlotte, NC 28216-2859 | 2020-09-08 |
| 1720692833 | Tgh Phase 2 | Community/Behavioral Health | 1121 Old Concord Rd Ste 14, Salisbury, NC 28146-1473 | 2020-09-04 |
| 1669086948 | October Road, Inc. | Community/Behavioral Health | 1304 Plaza Dr Ste 2312, Burlington, NC 27215-7165 | 2020-09-03 |
| 1225640188 | Flovi of Nc Inc. | Community/Behavioral Health | 1916 Sunset Ave, Rocky Mount, NC 27804-2520 | 2020-08-20 |
| 1275145658 | Next Level Counseling, Pllc | Community/Behavioral Health | Tele-therapy Only, Cary, NC 27511 | 2020-08-18 |
| 1023628872 | Jonathan Mccrary | Community/Behavioral Health | 5745 Bramblegate Rd Unit A, Greensboro, NC 27409-3019 | 2020-08-06 |
| 1841809746 | Ryan's Place, LLC | Community/Behavioral Health | 6000 Fairview Rd Ste 1259, Charlotte, NC 28210-2224 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
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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.