Active NPI
LCS-Al LLC
- Skilled Nursing Facility
- Dallas, TX
National Provider Identifier
1336552157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 137363
- Legal business name
- LCS-AL LLC
- Practice address
- 1010 Emerald Isle Dr
Dallas, TX 75218-3980 - Phone
- (214) 319-9184
- NPI assigned
- Jun 9, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael J. Andreasen
- Title
- Senior Vice President
- Phone
- (515) 875-4500
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 138394 | TX | |
| Skilled Nursing Facility | 314000000X | 137363 | TX | Primary |
Addresses
Primary practice location
1010 Emerald Isle Dr
Dallas, TX 75218-3980
Mailing address
1010 Emerald Isle Dr
Dallas, TX 75218-3980
Phone (214) 319-9184
Other names 1
- Autumn Leaves
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1104840545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715817600000",
"number": "1336552157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 EMERALD ISLE DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752183980",
"telephone_number": "214-319-9184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 EMERALD ISLE DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752183980",
"telephone_number": "214-319-9184"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LCS-AL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-06-09",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A",
"authorized_official_last_name": "ANDREASEN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "515-875-4500",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "TX",
"license": "138394",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TX",
"license": "137363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Autumn Leaves",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.