SOUTHERN ASSISTED LIVING, LLC.


Address: 3619 S Mebane St, Burlington, NC 27215-5221
Phone: 3365380367

SOUTHERN ASSISTED LIVING, LLC. (NPI# 1194881581) 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) 1194881581
Entity Type Organization
Organization Name SOUTHERN ASSISTED LIVING, LLC.
Other Organization Name CLARE BRIDGE AT BURLINGTON MANOR
Practice Address 3619 S Mebane St
Burlington
NC 27215-5221
Mailing Address 6737 W Washington St
Suite 2300
Milwaukee
WI 53214-5647
Practice Telephone 3365380367
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 7804073 05

Other Provider/Organization Names

Other Name Type Code
Clare Bridge at Burlington Manor Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1548326945 Southern Assisted Living, LLC. Assisted Living Facility 1750 Robinwood Rd, Gastonia, NC 28054-1664 2006-12-29
1417013822 Southern Assisted Living, LLC. Assisted Living Facility 2806 Peachtree Rd, Statesville, NC 28625-8204 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 3619 S MEBANE ST
City BURLINGTON
State NC
Zip Code 27215-5221

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1861911968 Michael Frey Pharmacist 2344 South Church St, Burlington, NC 27215 2017-09-11
1174043822 Comfort Medical Supply LLC Durable Medical Equipment & Medical Supplies 1244 Plaza Dr, Burlington, NC 27215 2017-06-23
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1912459132 Herb Mccandless Jr. Non-emergency Medical Transport (VAN) 4412 Dogwood Rd, Burlington, NC 27215 2016-11-04
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1669720819 Lucy Wessinger Menefee Registered Nurse Unc Nephrology and Hypertension, 3325 Garden Road, Burlington, NC 27215 2012-08-20
1154685402 Sheryl Harper Social Worker 2815 North Church Street, Burlington, NC 27215 2012-07-02
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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
1376059709 A.d.e.p.t. Programs, Inc. Assisted Living Facility 1701 Salem Rd Apt O11, Burlington, NJ 08016-8117 2017-12-21
1033625686 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 79, Burlington, NJ 08016-4012 2017-12-19
1124534771 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 89, Burlington, NJ 08016-4012 2017-12-19
1952817504 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 99, Burlington, NJ 08016-4012 2017-12-19
1861908410 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 255, Burlington, NJ 08016-4012 2017-12-19
1144736794 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 267, Burlington, NJ 08016-4012 2017-12-19
1023524675 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 279, Burlington, NJ 08016-4012 2017-12-19
1053827600 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 289, Burlington, NJ 08016-4012 2017-12-19
1114433760 A.d.e.p.t. Programs, Inc. Assisted Living Facility 309 Northgate Vlg Apt 303, Burlington, NJ 08016-4012 2017-12-19
1790290641 A.d.e.p.t. Programs, Inc. Assisted Living Facility 1701 Salem Rd Apt O5, Burlington, NJ 08016-3158 2017-12-13
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City BURLINGTON
Zip Code 27215

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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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