Lake Park Group, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LAKE PARK GROUP, LLC

Doing business as

Lake Park

Practice address

2114 W Grant Rd
24
Tucson, AZ 85745-1141

Phone

(520) 365-2025

Fax

(520) 365-2027

NPI assigned

Aug 23, 2007

Organization subpart

No

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

Authorized official

Name

Miriam Cosey

Title

Administrator

Phone

(520) 262-5583

Specialties & licenses 2

Addresses

Other names 1

• Lake Park Doing business as

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1578756334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 W GRANT RD",
            "address_2": "24",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451141",
            "telephone_number": "520-365-2025",
            "fax_number": "520-365-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 W GRANT RD",
            "address_2": "24",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451141",
            "telephone_number": "520-365-2025",
            "fax_number": "520-365-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PARK GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "COSEY",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "520-262-5583"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Warwick Laing
• Susan Jean Lainson
• Audrette Denise Laird
• Glenda Monreal Laird, M.ED.
• Martha E Laird, MD
• Jeffrey Michael Lake, DMD
• Jessica Ann Lakey, RRT
• Jasmine Lakhani, DMD
• Jamie Lakin, LCSW
• Pooja Kanhya Lal, MD

• Community/Behavioral Health Agency in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.