Lakeport Lodge of Love

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

LAKEPORT LODGE OF LOVE

Practice address

11585 FM 349
A
Longview, TX 75603-7562

Phone

(903) 702-3616

NPI assigned

Sep 1, 2015

Last updated

Sep 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Dorcas Maria Dunlap-Brown

Title

Program Manager

Phone

(903) 702-3616

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1659748002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11585 FM 349",
            "address_2": "A",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756037562",
            "telephone_number": "903-702-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11585 FM 349",
            "address_2": "A",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756037562",
            "telephone_number": "903-702-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEPORT LODGE OF LOVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "DUNLAP-BROWN",
        "authorized_official_first_name": "DORCAS",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "903-702-3616",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.