Lavender Ridge Inc

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

LAVENDER RIDGE INC

Practice address

1103 N Maple St
Effingham, IL 62401-1793

Phone

(217) 342-4150

Fax

(217) 342-4199

NPI assigned

Sep 24, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Keesha Wood-Smith

Title

Regional Director

Phone

(217) 342-4150

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1255767166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 N MAPLE ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011793",
            "telephone_number": "217-342-4150",
            "fax_number": "217-342-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 N MAPLE ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011793",
            "telephone_number": "217-342-4150",
            "fax_number": "217-342-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER RIDGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "WOOD-SMITH",
        "authorized_official_first_name": "KEESHA",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "217-342-4150",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Ann Larimer, LPN
• Nicole K Larsen, HIS
• Brian J Larson, CNIM
• Rick K Lasher, M.D.
• Heather Jean Latta
• Lawrence Leventhal MD PC
• Molly Sue Ledbetter
• Frank S Lee, M.D.
• Matthew Lee
• Lawrence Leventhal, M.D.

• Alzheimer Center (Dementia Center) in Effingham, IL
• Providers in Effingham, IL by specialty
• Alzheimer Center (Dementia Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.