Organization Active NPI

New Town Health Support Corporation

Doing business as Lakeside Community Living Center

  • Assisted Living Facility
  • New Town, ND
National Provider Identifier
1225437460
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
8088 Issued in ND
Legal business name
NEW TOWN HEALTH SUPPORT CORPORATION
Doing business as
Lakeside Community Living Center
Practice address
603 1St Street NW
New Town, ND 58763
Phone
(701) 627-4711
Fax
(701) 627-4013
NPI assigned
Aug 13, 2014
Last updated
Aug 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Authorized official

Name
Jeanine Ann Uran
Title
Administrator
Phone
(701) 627-4711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 8088 ND Primary

Addresses

Primary practice location

603 1St Street NW
New Town, ND 58763

Mailing address

PO Box 818
New Town, ND 58763
Phone (701) 627-4711

Other names 1

  • Lakeside Community Living Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1225437460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "58763",
            "telephone_number": "701-627-4711",
            "fax_number": "701-627-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 1ST STREET NW",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "58763",
            "telephone_number": "701-627-4711",
            "fax_number": "701-627-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW TOWN HEALTH SUPPORT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "URAN",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-627-4711"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ND",
            "license": "8088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Community Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Town, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.