Lakeshore Intergenerational School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

LAKESHORE INTERGENERATIONAL SCHOOL

Practice address

18025 Marcella Rd
Cleveland, OH 44119

Phone

(216) 456-2086

Fax

(216) 391-4770

NPI assigned

Jul 29, 2014

Last updated

Sep 6, 2014By 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

Charles E. Daane

Title

Cfo

Phone

(216) 456-2086

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409961600000",
    "number": "1710395264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18025 MARCELLA RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44119",
            "telephone_number": "216-456-2086",
            "fax_number": "216-391-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18025 MARCELLA RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44119",
            "telephone_number": "216-456-2086",
            "fax_number": "216-391-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE INTERGENERATIONAL SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-09-06",
        "status": "A",
        "authorized_official_last_name": "DAANE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "216-456-2086"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Point Medical Group, LLC
• Marisa Rachel Imbroane Lake, MD
• Tonjania Monae Lake, LPN
• Ammaar Abdullah Lakes
• Valerie Suzanne Lakes, APRN
• Lakeshore Pond LLC
• Lakeside Preparatory Academy
• Lakewood Ambulatory Foot Cen (Lakewood Ambulatory Foot Center)
• Lakewood Hospital Professional Services
• Lakeyta's Fingerprint Service LLC

• Local Education Agency (LEA) in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Local Education Agency (LEA) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2014; 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.