SOUTHERN ASSISTED LIVING, LLC. (NPI# 1386700284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386700284 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ASSISTED LIVING, LLC. |
| Other Organization Name | WEDDINGTON PARK |
| Practice Address |
2404 Plantation Center Dr Matthews NC 28105-5299 |
| Mailing Address |
6737 W Washington St Suite 2300 Milwaukee WI 53214-5647 |
| Practice Telephone | 9195628400 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2011-04-06 |
| Authorized Official Name | MARK OHLENDORF (CO-PRESIDENT) |
| Authorized Official Telephone | 4149185000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7803886 | 05 |
| Other Name | Type Code |
|---|---|
| Weddington Park | Doing Business As Name - Organization |
| 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 |
| 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 |
| 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 |
| Street Address |
2404 PLANTATION CENTER DR |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-5299 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164748240 | Laurie Ricciardi | Dietitian, Registered | 2404 Plantation Center Dr, Matthews, NC 28105-5299 | 2010-04-14 |
| 1679710099 | Brookdale Senior Living | Assisted Living Facility | 2404 Plantation Center Dr, Matthews, NC 28105-5299 | 2009-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003444258 | Trinity Developmental Center, LLC | Assisted Living Facility | 4027 Franklin Meadows Dr, Matthews, NC 28105-6935 | 2020-03-31 |
| 1679710099 | Brookdale Senior Living | Assisted Living Facility | 2404 Plantation Center Dr, Matthews, NC 28105-5299 | 2009-01-08 |
| 1568614469 | Wessel's Nursing Home of Matthews | Assisted Living Facility | 600 Fullwood Rd, Matthews, NC 28105-2659 | 2008-10-22 |
| 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 |
| 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 |
| 1326507260 | Alpha Magnolia Garden LLC | Assisted Living Facility | 930 Hwy. 158 Bus. East, Warrenton, NC 27589 | 2019-03-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHERN ASSISTED LIVING, LLC..
| 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.