LAKE LAGOS CARE LLC (NPI# 1497244693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497244693 |
| Entity Type | Organization |
| Organization Name | LAKE LAGOS CARE LLC |
| Practice Address |
1416 Country Club Rd Ennis TX 75119-2252 |
| Practice Telephone | 4693834776 |
| Practice Fax Number | 2147235928 |
| Mailing Telephone | 4693834776 |
| Mailing Fax Number | 2147235928 |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | SARAH ANNETTE KNAVEL ISOLA (CEO/PRESIDENT) |
| Authorized Official Telephone | 4693834776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 347C00000X | Private Vehicle | Transportation Services | ||
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
1416 COUNTRY CLUB RD |
| City | ENNIS |
| State | TX |
| Zip Code | 75119-2252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1952806085 | Ikids Pediatric Dentistry Ennis, Pllc | Dentist | 711 S Clay St Ste A, Ennis, TX 75119 | 2018-03-29 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| Find all providers in zip 75119 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538483 | Alejandra Melendez | Custodial Care Facility | 160 Santa Paula Dr, El Paso, TX 79927-1466 | 2020-11-04 |
| 1962001750 | Geov Divine Healthcare Services Inc. | Custodial Care Facility | 230 Darby Trails Dr, Sugar Land, TX 77479-5243 | 2020-10-22 |
| 1306444799 | St Leo Healthcare Services Inc | Custodial Care Facility | 4338 Berry Bend Ln, Richmond, TX 77406-7224 | 2020-10-16 |
| 1609473065 | Business Minds of Houston, LLC | Custodial Care Facility | 6102 Stonebury Ct, Sugar Land, TX 77479-5487 | 2020-10-07 |
| 1831704311 | Holistic Group LLC | Custodial Care Facility | 510 Cassia Way, Arlington, TX 76002-4520 | 2020-09-11 |
| 1619581170 | Unconditional Love Adult Family Homes | Custodial Care Facility | 3906 Waterproof, Killeen, TX 76549-4404 | 2020-09-02 |
| 1871105924 | Beezway Inc | Custodial Care Facility | 6100 Verandas Cir Apt 837, Fort Worth, TX 76132-4166 | 2020-08-20 |
| 1972112266 | Texas Pro Homecare Inc. | Custodial Care Facility | 2706 Seabiscuit Road, Celina, TX 75009 | 2020-07-23 |
| 1598374787 | Anapa Healthcare Services LLC | Custodial Care Facility | 22430 Rustic Meadow Ct, Katy, TX 77494-8247 | 2020-07-23 |
| 1336766336 | Living Faith Community Home, Inc. | Custodial Care Facility | 10735 Braes Forest Dr, Houston, TX 77071-1501 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.