Ssa Johnson City Alf, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ACL000000125 Issued in TN

Legal business name

SSA JOHNSON CITY ALF, LLC

Practice address

406 E. Mountain View Road
Johnson City, TN 37601

Phone

(423) 282-0300

Fax

(423) 282-8117

NPI assigned

May 15, 2015

Organization subpart

Yes

Parent organization

SSA JOHNSON CITY ALF LLCAs reported in NPPES

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

Authorized official

Name

D. Lee Field

Title

Member

Phone

(425) 474-0425

Specialties & licenses 1

Addresses

Other names 1

• Broadmore Senior Living Doing business as

Part of

Ssa Johnson City Alf LLC

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1437537073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 E. MOUNTAIN VIEW ROAD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-282-0300",
            "fax_number": "423-282-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E. MOUNTAIN VIEW ROAD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-282-0300",
            "fax_number": "423-282-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSA JOHNSON CITY ALF, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSA JOHNSON CITY ALF LLC",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "FIELD",
        "authorized_official_first_name": "D. LEE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "425-474-0425"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TN",
            "license": "ACL000000125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadmore Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Ellis Sprabery, MD
• Jane Anne Sprinkle, LPN
• Harry Lee Spurling, MA LMFT LPCMHSP LSPE
• Phillip Jordan Spurlock, DO
• Meghana Srinivas, MD
• Kirsten Stacy
• Daia G Stager, LMSW # 10668
• Brittany Stahnke, LCSW
• Makayla E Stamey, MA
• Linda H Stamm, CRNA

• Assisted Living Facility in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Assisted Living Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.