Lillie House

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

LILLIE HOUSE

Doing business as

Lifes Vision LLC

Practice address

4618 Kinzie Ave
Racine, WI 53405-2212

Phone

(262) 634-6781

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Les L Higgenbottom, LCSW, CSAC

Title

Psychotherapist

Phone

(414) 732-4253

Specialties & licenses 1

Addresses

Other names 1

• Lifes Vision LLC Doing business as

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1104081942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4618 KINZIE AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534052212",
            "telephone_number": "262-634-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4618 KINZIE AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534052212",
            "telephone_number": "262-634-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLIE HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "HIGGENBOTTOM",
        "authorized_official_first_name": "LES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "414-732-4253",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, CSAC"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifes Vision LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Samantha Lins
• Thomas J Linstroth, DDS

• Adult Care Home Facility in Racine, WI
• Providers in Racine, WI by specialty
• Adult Care Home Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.