Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LIFESPAN, INC.
Active
Organization
LIFESPAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBIN DEVORE BA (VP CORPORATE COMPLIANCE/PROGRAM OPS)
(704) 944-5100
Entity
Organization
Contact information
Practice address
5400 TUCKASEEGEE RD, CHARLOTTE, NC 28208-2522
(704) 393-9376
(704) 944-5102
Mailing address
1511 SHOPTON RD, SUITE A, CHARLOTTE, NC 28217-3239
(704) 944-5100
(704) 944-5102
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
MHL-060-147
NC
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-060-147
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408802
—
NC
Enumeration date
01/30/2007
Last updated
11/05/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up