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LAKE PRINCE AT HOME LLC
NPI 1174112445
Hospice Care, Community Based in Suffolk, VA

Active since January 12, 2021CLIA 49D2144000 · Waiver
100 ANNA GOODE WAY, SUFFOLK, VA 23434(757) 923-5559(757) 257-0421 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 14, 2025, Jan 12, 2021 (2 updates tracked since 2021).

About Lake Prince At Home Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE PRINCE AT HOME LLC (NPI 1174112445) is a healthcare organization registered as a hospice care, community based in Suffolk, Virginia and active in the NPI registry since January 2021. The organization holds a CLIA Waiver certificate valid through February 7, 2028 and lists Lee B Syria, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1174112445
Entity TypeOrganization
Primary Taxonomy251G00000X
Legal Business NameLAKE PRINCE AT HOME LLC
Location Address100 ANNA GOODE WAYSuffolk, VA 23434-9236
Mailing Address100 Anna Goode WaySuffolk, VA 23434-9236 · (757) 923-5559 · Fax (757) 257-0421
Phone(757) 923-5559
Fax(757) 257-0421
Organization SubpartNo
Authorized OfficialLee B SyriaPresident And Ceo · (828) 465-8019
Enumeration DateJanuary 12, 2021
Last NPPES UpdateMarch 14, 20252 updates tracked since enumeration
NPPES CertifiedMarch 14, 2025
✔ NPI 1174112445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospice Care, Community BasedAgencies
Taxonomy Code251G00000X
100 ANNA GOODE WAY, Suffolk, VA 23434
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2144000

Lake Prince At Home · Suffolk, VA
Active · expires Feb 7, 2028
CLIA Number49D2144000
Laboratory TypeHome Health Agency
Certificate Effective DateFebruary 8, 2026
Certificate Expiration DateFebruary 7, 2028
Laboratory DirectorBrandi Spivey
Laboratory Phone(757) 923-5559
Laboratory LocationLake Prince At Home100 Anna Goode Way, Suffolk, VA 23434
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Hospice Care Quality CMS Care Compare

Quality measures, care settings and the Hospice Care Index for Lake Prince Woods At Home LLC (CMS certification number 491649), from CMS Care Compare.

Lake Prince Woods At Home LLC

Hospice · Suffolk, VA
OwnershipNon-Profit
CMS Certification Number491649
CMS RegionRegion 3
Medicare-Certified SinceApril 8, 2022
Location100 Anna Goode WaySuffolk, VA 23434 · Suffolk City County
Phone(757) 923-5559

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEXIS WHITESIDE
Occupational Therapist
100 ANNA GOODE WAY
SUFFOLK, VA 23434
Suffolk City (757) 923-5500
MRS. KRISTA C. STIRLING PT
Physical Therapist
100 ANNA GOODE WAY
SUFFOLK, VA 23434
Suffolk City (757) 539-5797
LAKE PRINCE CENTER, INC.
Skilled Nursing Facility
100 ANNA GOODE WAY
SUFFOLK, VA 23434
Suffolk City (757) 923-5500
MR. STEPHANIE SANDERS-HOWARD MOTR/L
Occupational Therapist
100 ANNA GOODE WAY, L.P.W.
SUFFOLK, VA 23434
Suffolk City (757) 539-1526
AUSTYN CAITLYN CHAPPELL
Physical Therapy Assistant
100 ANNA GOODE WAY
SUFFOLK, VA 23434
Suffolk City (757) 923-5500
JAIMIE PRUITT LPTA
Physical Therapy Assistant
100 ANNA GOODE WAY
SUFFOLK, VA 23434
Suffolk City (757) 923-5500
DANIELLE LINER COTA
Occupational Therapy Assistant
100 ANNA GOODE WAY
SUFFOLK, VA 23434
Suffolk City (757) 923-5500
DR. ALLISON ELAINE UPHOLD PT, DPT
Physical Therapist
100 ANNA GOODE WAY
SUFFOLK, VA 23434
Suffolk City (757) 623-5500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Prince At Home LLC's NPI number?

The NPI number for Lake Prince At Home LLC is 1174112445. It was assigned to this organization in the NPPES registry on January 12, 2021.

Where is Lake Prince At Home LLC located?

Lake Prince At Home LLC is located at 100 Anna Goode Way, Suffolk, VA 23434. The listed phone number is (757) 923-5559.

What is Lake Prince At Home LLC's specialty?

The primary specialty registered for this NPI is Hospice Care, Community Based with taxonomy code 251G00000X.

Does Lake Prince At Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2144000) is associated with this NPI, valid through February 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Lake Prince At Home LLC a Medicare-certified hospice?

Yes. Lake Prince Woods At Home LLC is a Medicare-certified hospice (CMS certification number 491649), certified since April 8, 2022.

When was this NPI record last updated?

The NPPES record for Lake Prince At Home LLC was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.