Lottie-Estelle Group Home, Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

808 Issued in VA

Legal business name

LOTTIE-ESTELLE GROUP HOME, INC

Practice address

4897 Hwy 47
Chase City, VA 23924-3606

Phone

(434) 372-0407

Fax

(434) 372-0394

NPI assigned

Oct 9, 2013

Last updated

Oct 9, 2013By 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

Mrs. Tiffany Tillerson Terry

Title

QMRP

Phone

(434) 372-0407

Specialties & licenses 1

Addresses

Other names 1

• United Steps Day Support Other name

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1053748954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4883 HWY 47",
            "city": "CHASE CITY",
            "state": "VA",
            "postal_code": "239243606",
            "telephone_number": "434-372-0407",
            "fax_number": "434-372-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4897 HWY 47",
            "city": "CHASE CITY",
            "state": "VA",
            "postal_code": "239243606",
            "telephone_number": "434-372-0407",
            "fax_number": "434-372-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTTIE-ESTELLE GROUP HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "TILLERSON",
        "authorized_official_title_or_position": "QMRP",
        "authorized_official_telephone_number": "434-372-0407",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "VA",
            "license": "808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Steps Day Support",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Healthy Living Supply LLC
• Mary Rose Jayme, NURSE PRACTITIONER
• Stephanie Sarver Jones, BCBA, LBA
• Brigitte Gil Lacy, MS, CCC-SLP
• Cheryl Evans Lard, O.T.R.
• Grant Lee Merrill, MPT
• Michael K Haskett OD PC
• Alyssa N Milam, FNP-C
• Angelic Mills
• New Directions Community Outreach Services

• Intellectual Disabilities Intermediate Care Facility in Chase City, VA
• Providers in Chase City, VA by specialty
• Intellectual Disabilities Intermediate Care Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.