Lucorja Family Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

FCI060069 Issued in NC

Legal business name

LUCORJA FAMILY CARE HOME

Practice address

5356 Coburg Ave
Charlotte, NC 28215-2202

Phone

(704) 563-1020

Fax

(704) 563-1072

NPI assigned

Nov 2, 2006

Last updated

Aug 21, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Corliss L Cooke

Title

President

Phone

(704) 563-1020

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1326126475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 FREEDOM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282081719",
            "telephone_number": "704-398-9574",
            "fax_number": "704-392-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5356 COBURG AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152202",
            "telephone_number": "704-563-1020",
            "fax_number": "704-563-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCORJA FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "CORLISS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-563-1020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCI060069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805039",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alura Diane Luck, BCBA
• Luckey Quality Home Care LLC
• Kaythelia Luckey
• Luckhardt, PLLC
• Ekachai Lucktong, MD
• Lucrative Transportation Solutions Inc
• Selina Lucuara
• Amanda Kelsey Ludwig
• Allison Mee Lueders
• Emma Lueders

• Assisted Living Facility in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.