The Place at South Park

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE PLACE AT SOUTH PARK

Practice address

2101 Runntmede Lane
Charlotte, NC 28209

Phone

(704) 525-5508

Fax

(503) 485-1279

NPI assigned

May 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jon Harder

Title

Ceo President

Phone

(503) 485-8697

Specialties & licenses 1

Addresses

Tax ID family

Place at Southpark Assisted Living and Memory Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Southpark Senior Living LLC

  dba Place at Southpark Assisted Living and Memory Care

  • Assisted Living Facility
  • Charlotte, NC
  • NPI 1982724100
  NPD tax ID

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689895716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-485-8697",
            "fax_number": "503-485-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 RUNNTMEDE LANE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28209",
            "telephone_number": "704-525-5508",
            "fax_number": "503-485-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PLACE AT SOUTH PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "503-485-8697"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Charlotte, NC
• Providers in Charlotte, 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 Aug 22, 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.