Colonial Park Adult Assisted Living

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

COLONIAL PARK ADULT ASSISTED LIVING

Practice address

1050 W Colonial Park Dr
Grand Ledge, MI 48837-2215

Phone

(517) 526-1195

Fax

(517) 626-2525

NPI assigned

Feb 7, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Lorraine Adele Morales

Title

Owner

Phone

(517) 526-1195

Specialties & licenses 1

Addresses

Other names 1

• Eagles Nest Adult Assisted Living Other name

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1639701600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13282 S HINMAN RD",
            "city": "EAGLE",
            "state": "MI",
            "postal_code": "488229637",
            "telephone_number": "517-526-1195",
            "fax_number": "517-626-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W COLONIAL PARK DR",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488372215",
            "telephone_number": "517-526-1195",
            "fax_number": "517-626-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL PARK ADULT ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_middle_name": "ADELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-526-1195",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagles Nest Adult Assisted Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Grand Ledge, MI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.