Lakeshore Adult Center

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

LAKESHORE ADULT CENTER

Practice address

21220 Center Ridge Rd
Rocky River, OH 44116-3289

Phone

(216) 219-1618

NPI assigned

Dec 22, 2020

Last updated

Dec 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dan Jennings

Title

Owner

Phone

(216) 219-1618

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1023605268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21220 CENTER RIDGE RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21220 CENTER RIDGE RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163289",
            "telephone_number": "216-219-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE ADULT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-219-1618"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1827081",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Kretch, DPM
• Jo Ann Beverly Kurek, LCSW/LISW
• Lindsay A Kwasny
• Junghae Helen Kwon, MD
• Sarah Lacy, LPCC
• Lakeshore Heart, Inc.
• Amy Lamantia, LPCC-S
• Cory Randall Lamar, DC
• Michelle Lamb, PT, DPT
• Manjola Lamcaj

• Developmentally Disabled Services Day Training Agency in Rocky River, OH
• Providers in Rocky River, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.