LIFESPAN INC. NPI 1316083371

NPI Information

NPI: 1316083371
Provider Name: LIFESPAN, INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1801 OAK ST
CHARLOTTE, NC
ZIP 28269
Phone: (704) 596-4135
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LIFESPAN, INC. is an intermediate care facility mentally retarded in Charlotte, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. LIFESPAN, INC. NPI is 1316083371. The provider is registered as an organization entity type.

The provider's business location address is:

1801 OAK ST
CHARLOTTE, NC
ZIP 28269-869
Phone: (704) 596-4135
Fax: (704) 598-3634

The provider's authorized official is Robin Devore .
The authorized official title is Vp Corporate Compliance/program Ops and has the following contact phone number (704) 944-5100.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 11/5/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	251C00000X	Day Training, Developmentally Disabled Services	MHL-060-018	NORTH CAROLINA	No
2	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	MHL-060-018	NORTH CAROLINA	No
3	315P00000X	Intermediate Care Facility, Intellectual Disabilities			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3408802	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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