NPIMap

Organization Active NPI

SNH NC Tenant LLC

Doing business as The Haven in the Village at Carolina Place

  • Assisted Living Facility
  • Pineville, NC
National Provider Identifier
1013564194
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SNH NC TENANT LLC
Doing business as
The Haven in the Village at Carolina Place
Practice address
13150 Dorman Rd
Pineville, NC 28134-9382
Phone
(704) 540-0155
Fax
(704) 540-7769
NPI assigned
Aug 22, 2019
Organization subpart
Yes
Parent organization
SNH NC TENANT LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer F. Mintzer
Title
President & Chief Operating Officer
Phone
(617) 796-8350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

13150 Dorman Rd
Pineville, NC 28134-9382

Mailing address

255 Washington St Ste 300
Newton, MA 02458-1634
Phone (617) 796-8350

Other names 1

  • The Haven in the Village at Carolina Place Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2060199Haven in the Village at Carolina Place13150 Dorman Road, Pineville, NC 28134Certificate of waiverJun 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
SNH NC Tenant LLC12 organizations share this tax ID, including this one
Part of
SNH NC Tenant LLC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1013564194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13150 DORMAN RD",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281349382",
            "telephone_number": "704-540-0155",
            "fax_number": "704-540-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH NC TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH NC TENANT LLC",
        "enumeration_date": "2019-08-22",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Haven in the Village at Carolina Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.