Well LCB Portfolio 1 Tenant, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WELL LCB PORTFOLIO 1 TENANT, LLC

Doing business as

The Residence at Freeman Lake

Practice address

4 Technology Dr
North Chelmsford, MA 01863-2438

Phone

(978) 458-0099

NPI assigned

Jan 21, 2020

Last updated

Jan 21, 2020By 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. Sharon Makowsky

Title

Assistant Vice President, Legal

Phone

(646) 677-8753

Specialties & licenses 1

Addresses

Other names 1

• The Residence at Freeman Lake Doing business as

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1700416526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EDGEWATER DR STE 101",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624644",
            "telephone_number": "781-619-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "city": "NORTH CHELMSFORD",
            "state": "MA",
            "postal_code": "018632438",
            "telephone_number": "978-458-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL LCB PORTFOLIO 1 TENANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "MAKOWSKY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "ASSISTANT VICE PRESIDENT, LEGAL",
        "authorized_official_telephone_number": "646-677-8753",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Residence at Freeman Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bethany Villa, PA-C
• Village Primary Care & Wellness PC
• Caitlin G. Waters, MD
• Kate Alissa Weber
• Lauri A Welch, NP
• Jessica Wieselquist, MD
• Antoinette Faith Willis
• Ronald P. Winfield, MD
• Karen Wolfendon, LMHC
• Cecillia Ying Ying Wong, M.D.

• Assisted Living Facility in North Chelmsford, MA
• Providers in North Chelmsford, MA by specialty
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.