Brookdale Skeet Club

LBN: Southern Assisted Living, Llc.
Brookdale Skeet Club is an health care organization with primary practice located at 1560 Skeet Club Rd , High Point NC 27265-9530. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Southern Assisted Living, Llc. can be contacted via phone (336) 869-0301, or through Leskowicz, Joanne K via phone (414) 918-5000.

Contact Information

Primary practice address
1560 Skeet Club Rd High Point NC 27265-9530
Phone: (336) 869-0301
Fax: (336) 869-0252
Website:
Map and Directions
Authorized official contact:
Name: Leskowicz, Joanne K
Phone: (414) 918-5000

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X

Profile Details

NPI number 1174689483
LBN Legal business name Southern Assisted Living, Llc.
DBA Doing business as Brookdale Skeet Club
Authorized official Leskowicz, Joanne K
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 29th, 2006
Last updated Apr 8th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174689483 NPPES
North Carolina MEDICAID 7804107

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