Southern Lifestyle Alf of Lake Placid LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11211 Issued in FL

Legal business name

SOUTHERN LIFESTYLE ALF OF LAKE PLACID LLC

Practice address

1297 US 27 N
Lake Placid, FL 33852-7907

Phone

(863) 465-0568

Fax

(863) 465-0575

NPI assigned

Feb 13, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Charles A Oakes

Title

Administrator

Phone

(863) 465-0568

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Southern Lifestyle Other name

Locations

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1528207693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 US 27 N",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338527907",
            "telephone_number": "863-465-0568",
            "fax_number": "863-465-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 US 27 N",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338527907",
            "telephone_number": "863-465-0568",
            "fax_number": "863-465-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN LIFESTYLE ALF OF LAKE PLACID LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-13",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "OAKES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "863-465-0568",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11211",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "FL",
            "license": "AL11211",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WAIVER",
            "identifier": "000266800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Lifestyle",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shamrock Drugs, LLC (Shamrock Pharmacy)
• Neil Stuart Shechtman, M.D.
• William Nolan Shriner, DDS
• Rene Smit, R.P.T.
• Southern Life Operating Investments LLC (Southern Lifestyles Senior Living Center)
• Staci Starcher
• Jamie Layne Stayer, ITDS
• Stephaniedelbert,Arnp,Inc
• Lawrence Dean Stidham, RPH
• Melissa Ann Stockenberg

• Assisted Living Facility in Lake Placid, FL
• Providers in Lake Placid, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; 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.