SNH SE Mooresville Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-049-030 Issued in NC

Legal business name

SNH SE MOORESVILLE TENANT LLC

Doing business as

Summit Place of Mooresville

Practice address

128 Brawley School Rd
Mooresville, NC 28117-9102

Phone

(704) 799-2712

Fax

(704) 799-2719

NPI assigned

Jul 22, 2011

Organization subpart

Yes

Parent organization

SNH SE MOORESVILLE TENANT LLCAs reported in NPPES

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

Addresses

Other names 1

• Summit Place of Mooresville Doing business as

Part of

SNH SE Mooresville Tenant LLC

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1447538657",
    "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",
            "fax_number": "617-796-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 BRAWLEY SCHOOL RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179102",
            "telephone_number": "704-799-2712",
            "fax_number": "704-799-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH SE MOORESVILLE TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH SE MOORESVILLE TENANT LLC",
        "enumeration_date": "2011-07-22",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "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": "NC",
            "license": "HAL-049-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Place of Mooresville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Place of Mooresville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Kevin Smith, PHARM D, CGP, FASCP
• Samuel Clarkman Smith, DDS
• Shelby Smith
• SMPT Physical Therapy & Wellness LLC
• Angela Shirk Sneed, ATC, LAT
• Shannon Margaret Snipe, D.M.D
• Petros Agapios Sofroniou, MD
• Chloe Solek, MA, LMFTA
• Cody Solesbee, PH.D.
• Daniel Sonntag, CRNA

• Assisted Living Facility in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.