Lavender Mountain Senior Living, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAVENDER MOUNTAIN SENIOR LIVING, INC.

Practice address

500 Eagle Lake TRL
Rome, GA 30165-2246

Phone

(706) 728-3600

NPI assigned

Sep 15, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Nick Lancaster, ADMINISTRATOR

Title

Administrator

Phone

(170) 672-8360

Specialties & licenses 1

Addresses

Other names 1

• Magnolia Place Nursing and Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Skilled nursing facility certification: CCN 115774

Legal name

LAVENDER MOUNTAIN SENIOR LIVING, INC.

Doing business as

MAGNOLIA PLACE NURSING AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 20, 2021

Last certification

Sep 15, 2024

Beds

34

Ownership / control type

Nonprofit Corporation

Organization structure

LLCNon-profit

Incorporated

Dec 14, 2020 in GA

Enrollment address

500 Eagle Lake TRL
Rome, GA 30165-2246

Nursing home name

MAGNOLIA PLACE NURSING AND REHABILITATION

Listed as

Magnolia Place Nursing and RehabilitationCCN 115774

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

May 20, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3429.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Shelle Rae Glover, M.D.

  • Family Medicine Physician
  • Rome, GA
  • NPI 1003110743

  Adp of the SNF

  CMS ownership
• Pharmacy Partners of Ga

  • Long Term Care Pharmacy
  • Kennesaw, GA
  • NPI 1285837922

  Adp of the SNF

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Shelle Rae Glover, M.D.

  • Family Medicine Physician
  • Rome, GA
  • NPI 1003110743

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1124633268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 EAGLE LAKE TRL",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652207",
            "telephone_number": "706-728-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EAGLE LAKE TRL",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652246",
            "telephone_number": "706-728-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER MOUNTAIN SENIOR LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "LANCASTER",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "170-672-8360",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Place Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephan J Lapointe, DPM/PHD
• Heather Danielle Laseter, PA-C
• Louis Lataif Jr., M.D.
• Lauren Sorrow LLC
• Lavender Mountain Counseling
• Larry Alan Lavender, CRNA
• Sabrina Faith Lawley, AUD
• Lawrence M Arkin MD
• Douglas Ross Lawrence, MD
• James Lawrence III, M.D.

• Skilled Nursing Facility in Rome, GA
• Providers in Rome, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.