Eastbrook Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EASTBROOK CENTER LLC

Doing business as

Stonerise Charleston

Practice address

3819 Chesterfield Ave
Charleston, WV 25304-2647

Phone

(304) 925-4771

Fax

(304) 925-1343

NPI assigned

Aug 20, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence A Pack

Title

Owner/Manager

Phone

(304) 343-1950

Specialties & licenses 2

Addresses

Other names 1

• Stonerise Charleston Doing business as

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1972936482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHAPPELL RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042704",
            "telephone_number": "304-343-1950",
            "fax_number": "304-343-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 CHESTERFIELD AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042647",
            "telephone_number": "304-925-4771",
            "fax_number": "304-925-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTBROOK CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "304-343-1950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "WV",
            "license": "65",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonerise Charleston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John David Earley
• Jerry L Early
• Savana Beth Earnest, M.A, ED.S, NCSP
• Destiny Easley
• Amber East
• Dillon Easter
• Kelsey Easter, LPN
• Lauren Ashley Easter
• Christopher James Easton, PMHNP-BC
• Melissa Easton

• Skilled Nursing Facility in Charleston, WV
• Providers in Charleston, WV by specialty
• Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.