Life Stages Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

FCL-079-100 Issued in NC

Legal business name

LIFE STAGES ASSISTED LIVING LLC

Practice address

424 Glovenia St
Eden, NC 27288-4844

Phone

(336) 623-1093

NPI assigned

Oct 21, 2015

Organization subpart

No

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

Authorized official

Name

Torey Morris

Title

Administrator

Phone

(732) 330-8683

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1699147314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3066",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241153066",
            "telephone_number": "732-330-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 GLOVENIA ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272884844",
            "telephone_number": "336-623-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE STAGES ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "TOREY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-330-8683"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL-079-100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Okafor Mang Lekwuwa, MD
• John Lesueur, D.C.
• Felicia Lewis
• Jacqueline Lenore Lewis, RN
• Kimberly Hines Lewis, COTA/L
• Audrey Lynn Lovelace, LMBT 09629
• Erica Renee Mabry, PHARMD
• Larry Scott Maddy, OTR L CHT
• Majeski Home Health Agency
• Betty J Marshall, NP

• Assisted Living Facility in Eden, NC
• Providers in Eden, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.