LIFESPAN INC (NPI# 1477099752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477099752 |
| Entity Type | Organization |
| Organization Name | LIFESPAN INC |
| Practice Address |
4806 Farm Pond Ln Charlotte NC 28212-8558 |
| Mailing Address |
1511 Shopton Rd Suite A Charlotte NC 28217-3239 |
| Practice Telephone | 7045367739 |
| Mailing Telephone | 7049445100 |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |
| Authorized Official Name | ROBIN DEVORE (VP CORPORATE COMPLIANCE AND PROGRAM) |
| Authorized Official Telephone | 7049445100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MHL-060-1336 | 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 |
| 1245776533 | Lifespan Inc | Community/Behavioral Health | 6123 Woodthrush Dr, Charlotte, NC 28227-1027 | 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 |
4806 FARM POND LN |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28212-8558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371250 | Amy Sierra Conner | Counselor | 5700 Executive Drive Suite 110, Charlotte, NC 28212 | 2019-11-25 |
| 1700447307 | Nagarani Nagarajan Dds.,pllc | Clinic/Center | 2510 Vista Drive, Suite 100, Charlotte, NC 28212 | 2019-06-25 |
| 1700441011 | Khadija Brown | Counselor | 6601 English Hills Dr, Charlotte, NC 28212 | 2019-05-02 |
| 1245711514 | Savannah Huneycutt | Dentist | 6708 Albemarle Road, Charlotte, NC 28212 | 2018-08-24 |
| 1417435710 | Porcelain Dolls of The Carolinas, Inc | Clinic/Center | 5835 Executive Center Dr # 101-i, Charlotte, NC 28212 | 2018-07-30 |
| 1447701511 | Christine Walker Physical Therapy, LLC | Clinic/Center | 8850 Monroe Rd, Charlotte, NC 28212 | 2016-10-24 |
| 1013376128 | Colby Edward Joyner | Physician Assistant | 7005 Wallace Rd Ste 600, Charlotte, NC 28212 | 2016-02-17 |
| 1760814412 | Nguyen Tri Nguyen, Dds, Pa | Dentist | 6404 Albemarle Road, #c, Charlotte, NC 28212 | 2013-08-05 |
| 1477806834 | Tara Thompson | Counselor | 6900 Democracy Dr., Charlotte, NC 28212 | 2012-10-23 |
| 1568711109 | Mary Dianne Branch | Counselor | 8130 Runaway Bay Drive Apt Q, Charlotte, NC 28212 | 2012-08-29 |
| Find all providers in zip 28212 | ||||
| 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.