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SOUTHPARK SENIOR LIVING LLC

Alzheimer Center

Charlotte, North Carolina

Provider NPI: 1982724100

Organization Information:
Organization Name:  SOUTHPARK SENIOR LIVING LLC


Practice Location:
2101 RUNNYMEDE LN  CHARLOTTE, NC 28209 US
Tel: 704-525-5508  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N311500000XNursing & Custodial Care Facilities
Alzheimer Center (Dementia Center)
NCHAL060076
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility
NCHAL060076

Other Provider Identifiers:

IssuerNumberStateType
7805207NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ALZHEIMERS JOBS NC - Page 1