Lifetime Serenity Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

30AL3431-A Issued in MD

Legal business name

LIFETIME SERENITY ASSISTED LIVING

Practice address

8507 Liberty Rd
Randallstown, MD 21133-4833

Phone

(410) 496-9105

Fax

(410) 496-9109

NPI assigned

Jan 20, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Donovan Parkes, MDNPI 1811964133

Title

Physician

Phone

(410) 428-1382

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donovan Parkes, MD

  • Family Medicine Physician
  • Randallstown, MD
  • NPI 1811964133
  NPD (past) Authorized official

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1669919387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 MENLO DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153826",
            "telephone_number": "410-358-4401",
            "fax_number": "410-358-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334833",
            "telephone_number": "410-496-9105",
            "fax_number": "410-496-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME SERENITY ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "PARKES",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "410-428-1382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "30AL3431-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Randallstown, MD
• Providers in Randallstown, 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 Jan 20, 2017; 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.