Lan Deptford, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LAN DEPTFORD, LLC

Practice address

1674 Delsea Drive
Woodbury, NJ 08096-4117

Phone

(856) 209-4956

NPI assigned

Oct 24, 2017

Organization subpart

No

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

Authorized official

Name

Richard Thompson

Title

Member

Phone

(540) 364-0155

Specialties & licenses 1

Addresses

Other names 1

• Fox Trail at Tall Pines Doing business as

Locations

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1891206314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 N. CENTRAL AVENUE",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "07466",
            "telephone_number": "201-368-7070",
            "fax_number": "201-368-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1674 DELSEA DRIVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080964117",
            "telephone_number": "856-209-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAN DEPTFORD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "540-364-0155"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fox Trail at Tall Pines",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Kott
• Marlene Kovac, RPH
• Makbulmian Kureshi, DO
• Sharonda Kyles
• Nicole Lamarra Smith, LPC
• Jason William Lang, LMFT
• Michele Lanza, APN
• Jeffrey Larkin, MD
• Peter Larocco
• Kristin Latimer, LAC

• Assisted Living Facility in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.