Organization
LIFESPAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEIGH DERBY (CEO/PRESIDENT)
(704) 944-5100
Entity
Organization
Contact information
Practice address
908 MCCLELLAN PL, GREENSBORO, NC 27409-8929
(336) 852-1495
(336) 855-9994
Mailing address
200 CLANTON RD, CHARLOTTE, NC 28217-1446
(704) 944-5100
(704) 944-5102
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
MHL-041-508
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8702247
—
NC
Enumeration date
11/09/2010
Last updated
11/09/2010
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