A Great Place to Stay LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

A GREAT PLACE TO STAY LLC

Practice address

35580 N Knowles Rd
Lake Villa, IL 60046-9026

Phone

(920) 204-2722

NPI assigned

Mar 31, 2020

Last updated

Mar 31, 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

Veronica Clark

Title

President

Phone

(920) 204-2722

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1053949404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 PARK AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162204",
            "telephone_number": "920-204-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35580 N KNOWLES RD",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469026",
            "telephone_number": "920-204-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A GREAT PLACE TO STAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-204-2722"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.