Lasalle TLC Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12721 Issued in FL

Legal business name

LASALLE TLC ASSISTED LIVING LLC

Practice address

585 Allen Dr
Merritt Island, FL 32952-4990

Phone

(772) 501-4756

Fax

(321) 806-4601

NPI assigned

Sep 13, 2015

Organization subpart

No

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

Authorized official

Name

Sally Hayes Williams

Title

Administrator

Phone

(772) 501-4756

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1442102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442102400000",
    "number": "1891163481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 ALLEN DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524990",
            "telephone_number": "772-501-4756",
            "fax_number": "321-806-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 ALLEN DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524990",
            "telephone_number": "772-501-4756",
            "fax_number": "321-806-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASALLE TLC ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-13",
        "last_updated": "2015-09-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "HAYES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-501-4756"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2015; 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.