NPIMap

Organization Active NPI

Marshall Lake Healthcare LLC

  • Assisted Living Facility
  • Houston, TX
National Provider Identifier
1245016328
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
MARSHALL LAKE HEALTHCARE LLC
Practice address
7450 Willow Chase Blvd
Houston, TX 77070-5867
Phone
(281) 807-4744
Fax
(281) 807-6626
NPI assigned
Sep 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

7450 Willow Chase Blvd
Houston, TX 77070-5867

Mailing address

7450 Willow Chase Blvd
Houston, TX 77070-5867
Phone (281) 807-4744

Other names 1

  • Champions Healthcare at Willowbrook Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marshall Lake Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1245016328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 WILLOW CHASE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770705867",
            "telephone_number": "281-807-4744",
            "fax_number": "281-807-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 WILLOW CHASE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770705867",
            "telephone_number": "281-807-4744",
            "fax_number": "281-807-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL LAKE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champions Healthcare at Willowbrook",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.