Organization
LIFESPAN, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVAN CLONINGER (CEO/PRESIDENT)
(704) 944-5100
Entity
Organization
Contact information
Practice address
2398 FONTANA RD, ROBBINSVILLE, NC 28771-8973
(828) 735-3181
Mailing address
200 CLANTON RD, CHARLOTTE, NC 28217-1446
(704) 944-5100
(704) 944-5102
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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