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General NPI Number Information
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NPI Number | 1245995513
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Entity Type | Organization
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Legal Business Name | LIFESPAN HEALTHCARE, LLC
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1629 K ST NW STE 300
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City | WASHINGTON
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State | DC
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Zip | 20006-1631
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Country | US
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Telephone | 240-593-1485
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Fax |
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Provider Business Mailing Address
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Address Line | 8101 SANDY SPRING RD STE E-18
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City | LAUREL
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State | MD
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Zip | 20707-3596
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Country | US
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Telephone | 124-059-3148
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MS. HELEN VIBAN
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Credential | NP
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Telephone | 240-593-1485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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