Place At Southpark Assisted Living And Memory Care

LBN: Southpark Senior Living Llc
Place At Southpark Assisted Living And Memory Care is an health care organization with primary practice located at 2101 Runnymede Ln , Charlotte NC 28209-3316. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center). Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty. Southpark Senior Living Llc can be contacted via phone (704) 525-5508, or through Harder, Jon M via phone (503) 375-9016.

Contact Information

Primary practice address
2101 Runnymede Ln Charlotte NC 28209-3316
Phone: (704) 525-5508
Fax: (704) 525-2672
Website:
Map and Directions
Authorized official contact:
Name: Harder, Jon M
Phone: (503) 375-9016

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X HAL060076 North Carolina
Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) 311500000X HAL060076 North Carolina

Profile Details

NPI number 1982724100
LBN Legal business name Southpark Senior Living Llc
DBA Doing business as Place At Southpark Assisted Living And Memory Care
Authorized official Harder, Jon M
Entity Organization
Organization subpart 1 No
Enumeration date Mar 30th, 2007
Last updated Jul 23rd, 2008 - about 16 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 1982724100 NPPES
North Carolina MEDICAID 7805207

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