Organization · Type 2 NPI

Lifespan, Inc.

Intellectual Disabilities Intermediate Care Facility · Charlotte, NC

NPI number 1619013695 Active

Practice location

628 Flowe Dr
Charlotte, NC 28213-5607

Call (704) 598-6002 Map

Fax (704) 944-5102

Mailing address

1511 Shopton Rd, Suite A
Charlotte, NC 28217-3239

Specialties and licenses

TaxonomyCodeLicense
Developmentally Disabled Services Day Training Agency 251C00000XMHL-060-150 (NC)
Intellectual Disabilities Intermediate Care Facility Primary 315P00000XNone listed
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000XMHL-060-150 (NC)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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About NPI 1619013695

Lifespan, Inc.'s National Provider Identifier is 1619013695, issued on Jan 29, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Charlotte, NC. The record was last updated on Nov 5, 2018.