NPIMap

Organization Active NPI

Lum Personal Care Home, LLC

  • Nursing Care Agency
  • Canton, GA
National Provider Identifier
1467960039
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
RN235987 Issued in GA
Legal business name
LUM PERSONAL CARE HOME, LLC
Practice address
1132 Copper Creek Dr
Canton, GA 30114-8178
Phone
(631) 885-5510
NPI assigned
Jan 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Authorized official

Name
Mrs. Annie Lum, RN
Title
Director/Owner
Phone
(631) 885-5510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X RN235987 GA Primary

Addresses

Primary practice location

1132 Copper Creek Dr
Canton, GA 30114-8178

Mailing address

1132 Copper Creek Dr
Canton, GA 30114-8178
Phone (631) 885-5510

National Provider Directory

National Provider Directory
Tax ID family
Lum Personal Care Home LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1467960039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 COPPER CREEK DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148178",
            "telephone_number": "631-885-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 COPPER CREEK DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148178",
            "telephone_number": "631-885-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUM PERSONAL CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "LUM",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "631-885-5510",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "RN235987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.