Lake View Adult Family Home

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

LAKE VIEW ADULT FAMILY HOME

Practice address

W278N2456 Prospect Ave
Pewaukee, WI 53072-5220

Phone

(414) 379-9713

NPI assigned

Aug 19, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Douangmala Phrasavath, RN

Title

Registered Nurse

Phone

(414) 379-9713

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1250640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250640000000",
    "number": "1710119151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W278N2456 PROSPECT AVE",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725220",
            "telephone_number": "414-379-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W278N2456 PROSPECT AVE",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725220",
            "telephone_number": "414-379-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE VIEW ADULT FAMILY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-19",
        "last_updated": "2009-08-19",
        "status": "A",
        "authorized_official_last_name": "PHRASAVATH",
        "authorized_official_first_name": "DOUANGMALA",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "414-379-9713",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Labs
• Luann M Ladwig, APNP
• Lake Country Counseling Service
• Lake Country Foot & Ankle SC
• Lake Country Foot & Ankle, S.C.
• Lakefront Wellness Center, SC
• Abbey Mach Lamanna, D.D.S
• Shay Lange
• Heidi Laurel Lasnoski, PT
• Katie Laufenberg

• All providers in Pewaukee, WI
• Community Health Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.