Senior Life Choice of Salisbury, L.L.C.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

22AL019 Issued in MD

Legal business name

SENIOR LIFE CHOICE OF SALISBURY, L.L.C.

Doing business as

Lakeside Assisted Living

Practice address

1109 S Schumaker Dr
Salisbury, MD 21804-9256

Phone

(410) 749-4480

Fax

(410) 546-9710

NPI assigned

Jul 20, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Arlene Spack

Title

Executive Director

Phone

(410) 749-4480

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lakeside Assisted Living Doing business as

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1548460231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 S SCHUMAKER DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218049256",
            "telephone_number": "410-749-4480",
            "fax_number": "410-546-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 S SCHUMAKER DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218049256",
            "telephone_number": "410-749-4480",
            "fax_number": "410-546-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIFE CHOICE OF SALISBURY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "SPACK",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-749-4480",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "22AL019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9783677500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.