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General NPI Number Information
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NPI Number | 1366105934
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Entity Type | Organization
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Legal Business Name | LSLH WINDWARD LLC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 3300 WEBB BRIDGE RD
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City | ALPHARETTA
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State | GA
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Zip | 30005-4572
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Country | US
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Telephone | 770-291-6263
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2301
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City | STILLWATER
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State | MN
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Zip | 55082-2301
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Country | US
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Telephone | 513-422-7806
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | GREGG FOX
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Credential |
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Telephone | 651-342-2780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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