LP de Funiak Springs LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1583096 Issued in FL

Legal business name

LP DE FUNIAK SPRINGS LLC

Practice address

785 S 2ND St
Defuniak Springs, FL 32435-4903

Phone

(850) 892-2176

Fax

(850) 892-0781

NPI assigned

Aug 5, 2007

Organization subpart

Yes

Parent organization

LP CR HOLDINGS LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Harrison

Title

Cfo

Phone

(502) 568-7800

Specialties & licenses 1

Addresses

Other names 1

• Chautauqua Rehabilitation & Nursing Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1013108380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800",
            "fax_number": "502-568-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 S 2ND ST",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324354903",
            "telephone_number": "850-892-2176",
            "fax_number": "850-892-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP DE FUNIAK SPRINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LP CR HOLDINGS LLC",
        "enumeration_date": "2007-08-05",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1583096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chautauqua Rehabilitation & Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hans Lee, DMD
• Savannah Lynn Lerner
• Diane Campbell Little, ARNP
• Christina Lowry
• Robert Lowry, ARNP
• Edward Bryce Mandel, D.D.S., M.S.
• Libby Renae Marcolongo, LMFT
• Heather Lynn Marshall, BCBA
• Mash Inc
• Kristi Katherine Mason, LMT

• All providers in Defuniak Springs, FL
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.