Willowbrook West LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WILLOWBROOK WEST LLC

Practice address

507 NW Hall of Fame Dr
Lake City, FL 32055-4835

Phone

(386) 755-6560

NPI assigned

Feb 25, 2019

Organization subpart

No

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

Authorized official

Name

Eamon Burgess

Title

Ceo

Phone

(614) 440-4393

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1780141846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432013121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 NW HALL OF FAME DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554835",
            "telephone_number": "386-755-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWBROOK WEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "EAMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-440-4393"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randi Williams
• Tyeisha Williams
• Elaina Williamson, ARNP
• Meghann Elizabeth Williamson, APRN
• Deonna G Willis, APRN
• Vanessa R Wills
• Ashley Wilson
• Emily Wilson, PHARMD
• Joshua M Wilson, DC
• Mary Wilson

• Assisted Living Facility in Lake City, FL
• Providers in Lake City, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.