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Contact Information

LIFESPAN INCORPORATED
2070 RIVER ROAD
NORTH WILKESBORO, NC28659
 Phone: 704-944-5100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for LIFESPAN INCORPORATED

NPI Number 1639696941
LBN Legal business name LIFESPAN INCORPORATED
Authorized official ROBIN DEVORE - (VP CORPORATE COMPLIANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 08/28/2017
Last updated 08/28/2017 - About 9 years ago
Identifiers
NC License # 097-078
NC Medicaid 3408802
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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