SOUTHERN ASSISTED LIVING, LLC.


Address: 2806 Peachtree Rd, Statesville, NC 28625-8204
Phone: 7048721946

SOUTHERN ASSISTED LIVING, LLC. (NPI# 1417013822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417013822
Entity Type Organization
Organization Name SOUTHERN ASSISTED LIVING, LLC.
Other Organization Name STATESVILLE PLACE
Practice Address 2806 Peachtree Rd
Statesville
NC 28625-8204
Mailing Address 6737 W Washington St
Suite 2300
Milwaukee
WI 53214-5647
Practice Telephone 7048721946
Enumeration Date 2006-12-29
Last Update Date 2011-04-06
Authorized Official Name MARK OHLENDORF (CO-PRESIDENT)
Authorized Official Telephone 4149185000
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 310400000X Assisted Living Facility Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NC 7803880 05

Other Provider/Organization Names

Other Name Type Code
Statesville Place Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1194881581 Southern Assisted Living, LLC. Assisted Living Facility 3619 S Mebane St, Burlington, NC 27215-5221 2006-12-29
1548326945 Southern Assisted Living, LLC. Assisted Living Facility 1750 Robinwood Rd, Gastonia, NC 28054-1664 2006-12-29
1174689483 Southern Assisted Living, LLC. Assisted Living Facility 1560 Skeet Club Rd, High Point, NC 27265-9530 2006-12-29
1093871949 Southern Assisted Living, LLC. Assisted Living Facility 1717 Union Rd, Gastonia, NC 28054-5583 2006-12-28
1699831594 Southern Assisted Living, LLC. Assisted Living Facility 611 Brooks St, Wake Forest, NC 27587-2978 2006-12-28
1427114412 Southern Assisted Living, LLC. Assisted Living Facility 1145 Powell Rd, Lenoir, NC 28645-3655 2006-12-28
1083770937 Southern Assisted Living, LLC. Assisted Living Facility 17 Regional Dr, Pinehurst, NC 28374-8650 2006-12-28
1023174687 Southern Assisted Living, LLC. Assisted Living Facility 2441 E Broad St, Statesville, NC 28625-4407 2006-12-28
1518023183 Southern Assisted Living, LLC. Assisted Living Facility 201 W Hartley Dr, High Point, NC 27265-2843 2006-12-28
1356407217 Southern Assisted Living, LLC. Assisted Living Facility 2980 Reynolda Rd, Winston Salem, NC 27106-3047 2006-12-28

Other Data Sources

Entity Type Entity Name Entity Address
North Carolina Corporation Southern Assisted Living, LLC 111 Westwood Place, Suite 400 , Brentwood, TN 37027-5057
Virginia Business Entity Southern Assisted Living, LLC 111 WESTWOOD PL STE 400 , BRENTWOOD, TN 37027

Office Location

Street Address 2806 PEACHTREE RD
City STATESVILLE
State NC
Zip Code 28625-8204

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821232810 Arc Therapy Services LLC Clinic/Center 2806 Peachtree Rd, Statesville, NC 28625-8204 2009-04-22
1962534073 Heidi Rae Adams Physical Therapist 2806 Peachtree Rd, Statesville, NC 28625-8204 2007-03-12

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1730714163 Sandra Lourdes Mayta Counselor 1450 Fern Creek Drive, Statesville, NC 28625 2020-03-05
1023643582 Youngchi Chang Dds Pllc Dentist 964 Glenway Ave Ste A, Statesville, NC 28625 2020-03-05
1538799200 Nicole-marie Blischak Dentist 964 Glenway Dr, Ste A, Statesville, NC 28625 2020-01-22
1013575257 Sherry Neilson Registered Nurse 524 Signal Hill Rd, Statesville, NC 28625 2019-06-03
1770904328 Elinor Kyle Tyner Counselor 1206 Museum Road, Statesville, NC 28625 2013-12-30
1982031001 Tamiko Bradley Counselor 524 Signal Hill Dr Ext, Statesville, NC 28625 2013-10-03
1487932505 Nicole Weisner Winecoff Advanced Practice Midwife 1420 Fern Creek Drive, Statesville, NC 28625 2011-07-22
1538461967 Bethany J Sprague Nurse Practitioner 2632 Fines Creek Dr, Statesville, NC 28625 2010-11-17
1477789147 Greenbriar Primary Care, Pa Nurse Practitioner 308-c Mocksville Highway, Statesville, NC 28625 2009-06-08
1619122538 Phasebdevelopment Substance Abuse Rehabilitation Facility 113 Bethany Rd, Statesville, NC 28625 2008-11-19
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Taxonomy Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023174687 Southern Assisted Living, LLC. Assisted Living Facility 2441 E Broad St, Statesville, NC 28625-4407 2006-12-28
1295890309 Southern Assisted Living, LLC. Assisted Living Facility 2814 Peachtree Rd, Statesville, NC 28625-8204 2006-12-27
1225197239 Omega Investments Inc Assisted Living Facility 1372 Eufola Rd, Statesville, NC 28677 2006-12-06
1578583381 Piedmont Village At Statesville, Inc. Assisted Living Facility 1902 Ora Dr, Statesville, NC 28625-6343 2006-07-21
1689239923 Mill Creek Manor, LLC Assisted Living Facility 1902 Ora Dr, Statesville, NC 28625-6343 2019-05-02
1720313976 Aurora of Statesville, LLC Assisted Living Facility 1902 Ora Dr, Statesville, NC 28625-6343 2009-10-06
1720264146 Kyrie Health Properties 1, LLC Assisted Living Facility 1902 Ora Dr, Statesville, NC 28625-6343 2008-01-16
1659580819 Statesville Assisted Living, LLC Assisted Living Facility 2147 Davie Ave, Statesville, NC 28625-9200 2007-05-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1629689104 B&b Assisted Living Care LLC Assisted Living Facility 9461 Us Hwy 710s, Rowland, NC 28383 2020-08-10
1306465745 Cedar Senior Living, LLC. Assisted Living Facility 670 Cedar Lake Ln, Clinton, NC 28328-8986 2020-04-15
1003444258 Trinity Developmental Center, LLC Assisted Living Facility 4027 Franklin Meadows Dr, Matthews, NC 28105-6935 2020-03-31
1114562147 Taylor Care Group, LLC Assisted Living Facility 1188 Bertha Wilson Rd, Blanch, NC 27212-9795 2019-11-13
1710528377 Grace Village Inc Assisted Living Facility 501 River Bend Dr., Granite Falls, NC 28630 2019-10-04
1336799246 Tieshquanna Ciare Richardson Assisted Living Facility 312 Kilgo St, Clayton, NC 27520-1651 2019-09-13
1326695404 Snh Nc Tenant LLC Assisted Living Facility 5920 Mcchesney Dr, Charlotte, NC 28269-6238 2019-08-22
1659928174 Coastal Pointe Senior Living LLC Assisted Living Facility 5220 Ocean Hwy W, Shallotte, NC 28470-4006 2019-08-20
1861046674 A1a-arc of Dunn, LLC Assisted Living Facility 217 Jonesboro Rd, Dunn, NC 28334-6240 2019-07-30
1679137665 Kenzi Care LLC Assisted Living Facility 668 Wood Rd, Taylorsville, NC 28681 2019-04-25
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Competitor

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City STATESVILLE
Zip Code 28625

Improve Information

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Dataset Information

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.

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