Mooresville Senior Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-049-025 Issued in NC

Legal business name

MOORESVILLE SENIOR LIVING, LLC

Practice address

140 Carriage Club Dr
Mooresville, NC 28117-9284

Phone

(704) 658-1200

Fax

(503) 485-1279

NPI assigned

Sep 29, 2009

Organization subpart

No

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

Authorized official

Name

Shirley Dunn

Title

Cro Representative

Phone

(503) 485-4948

Specialties & licenses 2

Addresses

Other names 1

• Churchill Senior Living Doing business as

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254182400000",
    "number": "1972837631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021177",
            "telephone_number": "503-375-9016",
            "fax_number": "503-485-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 CARRIAGE CLUB DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179284",
            "telephone_number": "704-658-1200",
            "fax_number": "503-485-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORESVILLE SENIOR LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "CRO REPRESENTATIVE",
        "authorized_official_telephone_number": "503-485-4948"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-049-025",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NC",
            "license": "HAL-049-025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Churchill Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Sep 29, 2009; 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.