Organization
LIFESPAN INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN DEVORE (VP CORPORATE COMPLIANCE AND PROGRAM)
(704) 944-5100
Entity
Organization
Contact information
Practice address
532 PLEASANT VALLEY RD, MURPHY, NC 28906-2501
(704) 944-5100
Mailing address
1511 SHOPTON RD STE A, CHARLOTTE, NC 28217-3240
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL020075
NC
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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