Leisure Living Management of Fremont, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

23D0975403 Issued in MI

Legal business name

LEISURE LIVING MANAGEMENT OF FREMONT, INC.

Doing business as

Fountain View of Fremont - Laboratory

Practice address

102 Hillcrest Ave
Fremont, MI 49412-1348

Phone

(231) 924-5050

NPI assigned

Jul 9, 2010

Organization subpart

No

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

Authorized official

Name

Thomas Nobel

Title

President

Phone

(231) 924-5050

Specialties & licenses 1

Addresses

Other names 1

• Fountain View of Fremont - Laboratory Doing business as

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1336451145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HILLCREST AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121348",
            "telephone_number": "231-924-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HILLCREST AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121348",
            "telephone_number": "231-924-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISURE LIVING MANAGEMENT OF FREMONT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "NOBEL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-924-5050"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D0975403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain View of Fremont - Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Grace Lagare, PTR
• David Ervin Langholz, M.D.
• Heather Renae Lashuay, LLPC
• Gabrielle Ann Lawrence, DMD
• Kristin Lynn Le Bel, PA
• Mary Ethel Lobrigas, PT, DPT
• April Renea Lucht, FNP-C
• Laura Lyons, HIS
• Rebecca Macdonald
• Mark Warnement

• Clinical Medical Laboratory in Fremont, MI
• Providers in Fremont, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.