Southern Senior Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

034-01-011-1 Issued in GA

Legal business name

SOUTHERN SENIOR LIVING

Practice address

215 Sellers St
Douglas, GA 31533-4609

Phone

(912) 383-9883

Fax

(912) 383-8571

NPI assigned

Jul 7, 2010

Last updated

Jul 7, 2010By 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

Mrs. Beth M. Harper

Title

Ceo/Adminstrator

Phone

(912) 383-9883

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278460800000",
    "number": "1740592773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SELLERS ST",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315334609",
            "telephone_number": "912-383-9883",
            "fax_number": "912-383-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SELLERS ST",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315334609",
            "telephone_number": "912-383-9883",
            "fax_number": "912-383-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SENIOR LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-07-07",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO/ADMINSTRATOR",
        "authorized_official_telephone_number": "912-383-9883",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "034-01-011-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390875605A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Douglas, GA
• Providers in Douglas, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.