Lake Lagos Care LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

LAKE LAGOS CARE LLC

Practice address

1416 Country Club Rd
Ennis, TX 75119-2252

Phone

(469) 383-4776

Fax

(214) 723-5928

NPI assigned

May 3, 2018

Organization subpart

No

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

Authorized official

Name

Sarah Annette Knavel Isola

Title

Ceo/President

Phone

(469) 383-4776

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1497244693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 COUNTRY CLUB RD",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751192252",
            "telephone_number": "469-383-4776",
            "fax_number": "214-723-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 COUNTRY CLUB RD",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751192252",
            "telephone_number": "469-383-4776",
            "fax_number": "214-723-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE LAGOS CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "KNAVEL ISOLA",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "469-383-4776"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Sue King, PTA
• Janeal Louise Kitchens, NP
• Lindsey Koheel, PA-C
• Krimson Medical PLLC
• Charrissa Jane Laborn
• Lakewood Hills Internal Medicine, LLC
• Jedediah Larick, LCDC
• Larry W Dunkerley DPM PC
• Larry W. Treadaway, D.D.S., Inc.
• Danny Blayne Laws, M.D.

• All providers in Ennis, TX
• Adult Care Home Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.