Senior Lifestyles. LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

1000000021008 Issued in TN

Legal business name

SENIOR LIFESTYLES. LLC

Practice address

1125 Deer Creek Dr
Cookeville, TN 38501-6680

Phone

(931) 273-7900

NPI assigned

Apr 13, 2018

Last updated

Apr 13, 2018By 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

Brandi D Lawson, MBA

Title

Executive Director

Phone

(931) 273-7900

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1801383013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 W JACKSON ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013993",
            "telephone_number": "931-273-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 DEER CREEK DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385016680",
            "telephone_number": "931-273-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIFESTYLES. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "931-273-7900",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "TN",
            "license": "1000000021008",
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TN",
            "license": "1000000021008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q033896",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruthellen Elizabeth Sells, BEHAVIOR TECHNICIAN
• Tony Dale Sells, DPH
• Haley Semeniuk, BSN, RN, IBCLC
• Senior Life Management LLC (Home Instead Senior Care)
• Senior Lifestyles LLC
• Serenity Health LLC
• Serenity Mental Health
• Bobbi A. Severt, ATC
• Jennifer Paige Seymour
• James P Shaffer, MD

• Adult Mental Health Clinic/Center in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Adult Mental Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.