Lisa Marie Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LISA MARIE ASSISTED LIVING LLC

Practice address

1165 Lawanna Dr
Baxley, GA 31513-6810

Phone

(646) 479-3304

NPI assigned

Oct 2, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Ashney Harryton, RN

Title

President

Phone

(646) 479-3304

Specialties & licenses 1

Addresses

Other names 1

• LISA MARIE ASSISTED LIVING LLC Doing business as

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1598545295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 LAWANNA DR",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315136810",
            "telephone_number": "646-479-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 LAWANNA DR",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315136810",
            "telephone_number": "646-479-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA MARIE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "HARRYTON",
        "authorized_official_first_name": "ASHNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-479-3304",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LISA MARIE ASSISTED LIVING LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin O. Keown, M.D.
• Ernest Buford Kesler Jr., EDD
• Andrew Laves
• Dora Nayibe Laves, CMI
• Knicole A Lee, DNP,FNP-BC
• Timothy Neal Lovett, O.D.
• Renea McCall
• Vanacia Latrell McCall, LPN
• Jonathan Cade McCullar
• Myiesha Sellers McFarlin, NP

• Assisted Living Facility in Baxley, GA
• Providers in Baxley, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.