LIFESPAN INCORPORATED (NPI# 1811484884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811484884 |
| Entity Type | Organization |
| Organization Name | LIFESPAN INCORPORATED |
| Practice Address |
264 Lillie Ln Canton NC 28716-7900 |
| Mailing Address |
1511 Shopton Rd Ste A Charlotte NC 28217-3240 |
| Practice Telephone | 7049445100 |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | ROBIN DEVORE (VP CORPORATE COMPLIANCE AND OPERATI) |
| Authorized Official Telephone | 7049445100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3408802 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144717018 | Lifespan Incorporated | Community/Behavioral Health | 3529 Hatwynn Rd, Charlotte, NC 28269-1329 | 2018-04-17 |
| 1851888721 | Lifespan Incorporated | Community/Behavioral Health | 4322 Fairview Rd, Andrews, NC 28901-8114 | 2018-04-17 |
| 1316434285 | Lifespan Incorporated | Community/Behavioral Health | 944 Nc Highway 141, Murphy, NC 28906-6878 | 2018-04-17 |
| 1639696941 | Lifespan Incorporated | Community/Behavioral Health | 2070 River Road, North Wilkesboro, NC 28659 | 2017-08-28 |
| 1770007213 | Lifespan Incorporated | Community/Behavioral Health | 532 Pleasant Valley Rd, Murphy, NC 28906-2501 | 2017-07-26 |
| 1144683210 | Lifespan Incorporated | Community/Behavioral Health | 14020 Us 19, Andrews, NC 28901-8005 | 2016-04-05 |
| 1770070740 | Lifespan Incorporated | Community/Behavioral Health | 78 Market St, Maggie Valley, NC 28751-8594 | 2018-04-16 |
| 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 |
264 LILLIE LN |
| City | CANTON |
| State | NC |
| Zip Code | 28716-7900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699174987 | Ryan Scott Buchanan | Counselor | 118 Main St Fl 2, Canton, NC 28716 | 2014-08-22 |
| 1164689766 | Ann Davis Rest Home | Assisted Living Facility | 460 Beaverdam St, Canton, NC 28716 | 2008-05-21 |
| 1306991799 | William Courtenay Dinwiddie Jr. | Family Medicine | 55 Buckeye Cove Road, Canton, NC 28716 | 2007-01-24 |
| 1922175355 | Charles Richard Panther | Social Worker | 30 Pennsylvania Ave, Canton, NC 28716 | 2006-11-29 |
| 1932114881 | Ingles Markets Inc | Pharmacy | 630 Champion Dr, Canton, NC 28716-3032 | 2006-07-29 |
| 1083123608 | Ariana Debussey | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2017-09-26 |
| 1346580040 | Frank Cecil Etier Sr. | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2013-02-18 |
| 1346588431 | Anna Maria Apostolopoulos | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2013-01-23 |
| 1003171034 | Kelsie Paige Ormsby | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2012-07-05 |
| 1851568372 | Sandra Y Wyche | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2008-05-14 |
| Find all providers in zip 28716 | ||||
| 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 |
|---|---|---|---|---|
| 1407457864 | Initial Steps Behavioral and Learning Services | Community/Behavioral Health | 50203 Paine St, Canton, MI 48188-3332 | 2020-11-03 |
| 1891393328 | Hws Best Health LLC | Community/Behavioral Health | 3878 Old Hickory Ave Nw, Canton, OH 44718-3871 | 2020-10-16 |
| 1427675834 | Aba Helps | Community/Behavioral Health | 5 Stratford Rd, Canton, MA 02021-4213 | 2020-07-01 |
| 1487149662 | James Lee Hicks Jr. | Community/Behavioral Health | 4826 Cranberry Ave Nw, Canton, OH 44709-1317 | 2018-06-29 |
| 1023501467 | Wendy E Hixenbaugh | Community/Behavioral Health | 400 Tuscarawas St W # Stwe200, Canton, OH 44702-2044 | 2018-06-11 |
| 1770035487 | A B A Let's Play, Inc. | Community/Behavioral Health | 6304 Shipslanding Ave Nw, Canton, OH 44718 | 2016-10-28 |
| 1194276592 | Obtain The Promise LLC | Community/Behavioral Health | 189 Mill Creek Dr, Canton, GA 30115-6037 | 2016-10-20 |
| 1265985568 | Meah Counseling, LLC | Community/Behavioral Health | 5958 Canton Center Rd., Suite 900, Canton, MI 48187 | 2016-08-03 |
| 1245698356 | Meridian Behavioral Health Services | Community/Behavioral Health | 60 Thompson St, Canton, NC 28716-3325 | 2016-02-03 |
| 1275998569 | Marie Jean II | Community/Behavioral Health | 472 Crestmont Ln, Canton, GA 30114-8860 | 2015-12-31 |
| Find all providers in CANTON | ||||
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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.