Organization Active NPI

Stanley Total Living Center, Inc

  • Skilled Nursing Facility
  • Stanley, NC
National Provider Identifier
1407843097
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0386 Issued in NC
Legal business name
STANLEY TOTAL LIVING CENTER, INC
Practice address
514 Old Mount Holly Rd
Stanley, NC 28164-2191
Phone
(704) 263-1986
Fax
(704) 263-8959
NPI assigned
Sep 29, 2005
Last updated
Nov 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Mrs. Jennifer Defelice, RN
Title
Administrator
Phone
(704) 263-1986

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X NH0386 NC
Adult Care Home Facility 311ZA0620X NH0386 NC
Nursing Facility/Intermediate Care Facility 313M00000X NH0386 NC
Skilled Nursing Facility 314000000X NH0386 NC Primary

Addresses

Primary practice location

514 Old Mount Holly Rd
Stanley, NC 28164-2191

Mailing address

PO Box 489
Stanley, NC 28164-0489
Phone (704) 263-1986

Other identifiers 2

IdentifierTypeStateIssuer
3405264MedicaidNC
0086COtherNCPROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000805 NC Part A Provider - Skilled Nursing Facility 1456244102 Practice locations: Stanley, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407843097. Details of each certification follow.

Skilled nursing facility certification: CCN 345264

Legal name
STANLEY TOTAL LIVING CENTER, INC
Doing business as
STANLEY TOTAL LIVING CENTER, INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jul 23, 1987
Last certification
Oct 25, 2024
Beds
146 (106 certified)
Ownership / control type
Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 19, 1981 in NC
Enrollment address
514 Old Mount Holly Rd
Stanley, NC 28164-2191
Nursing home name
STANLEY TOTAL LIVING CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Stanley Total Living CenterCCN 345264 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 23, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10690.8 residents per day on average
Penalties (3 years)
1Fines totaling $31,967

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Stanley Total Living Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dana H Baker Individual Corporate DirectorBoard Memeber Jan 1, 2022 5.88%
Cathy H Kirkland Individual Corporate DirectorBoard Memeber Mar 1, 2021 5.88%
John D Nelson Individual Adp of the SNF Jan 1, 2010
Sharon Bryant Individual Corporate OfficerCfo Mar 31, 2008
Adp of the SNF Mar 31, 2008
Melissa Smith Individual Corporate DirectorBoard Member Gen Board Secretary Oct 1, 2008 5.88%
Rob McMinn Individual Corporate OfficerSecond Vice President Jan 1, 2013 5.88%
Corporate DirectorBoard Member Jan 1, 2012 5.88%
Teresa Neely Individual Corporate DirectorBoard Member Oct 1, 2008 5.88%
Jennifer Defelice Individual Corporate DirectorBoard Member Jan 1, 2022 5.88%
Operational/Managerial Control Oct 1, 2008
Adp of the SNF Oct 1, 2008
Allison D Crotts Individual Corporate OfficerExecutive Board Secretary Jan 1, 2018 5.88%
Corporate DirectorBoard Member Oct 1, 2015 5.88%
Elizabeth M Grice Individual Corporate Director Jan 1, 2019 5.88%
Steve Smith Individual Corporate OfficerOfficer Vice President of Board Jun 7, 2013 5.88%
Derrick a Gantt Individual Corporate DirectorBoard Member Jan 5, 2023 5.88%
Kevin G Mauney Individual Corporate Director Jan 1, 2019 5.88%
Ronnie Ensley Individual Corporate OfficerPresident Oct 1, 2008 5.88%
Judith Abernathy Individual Corporate DirectorBoard Member Jul 1, 2013 5.88%
Sandra Denise Mull Individual Adp of the SNF Jul 16, 1997
Deborah M Harper Individual Corporate DirectorDirector Jan 26, 2015 5.88%
Teresa West Individual Corporate DirectorBoard Member Oct 1, 2008 5.88%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1407843097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "STANLEY",
            "state": "NC",
            "postal_code": "281640489",
            "telephone_number": "704-263-1986",
            "fax_number": "704-263-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 OLD MOUNT HOLLY RD",
            "city": "STANLEY",
            "state": "NC",
            "postal_code": "281642191",
            "telephone_number": "704-263-1986",
            "fax_number": "704-263-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY TOTAL LIVING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "DEFELICE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-263-1986",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NC",
            "license": "NH0386",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "NH0386",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "NH0386",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405264",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "0086C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanley, NC

Sources for this page

Verify at the official NPI Registry.