Southern Living for Seniors of Louisburg NC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SOUTHERN LIVING FOR SENIORS OF LOUISBURG NC

Doing business as

Southern Living for Seniors

Practice address

361 Leonard Rd
Louisburg, NC 27549-8412

Phone

(850) 253-5990

NPI assigned

Sep 21, 2017

Organization subpart

No

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

Authorized official

Name

Charles Hendry

Title

Coo

Phone

(850) 253-5990

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southern Living for Seniors Doing business as

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506297600000",
    "number": "1992214084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 NE COUNTY ROAD 150",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323403617",
            "telephone_number": "850-464-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 LEONARD RD",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275498412",
            "telephone_number": "850-253-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN LIVING FOR SENIORS OF LOUISBURG NC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-25",
        "status": "A",
        "authorized_official_last_name": "HENDRY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "850-253-5990"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000000",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Living for Seniors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aria Smith
• Bernitta Smith, LPCA
• Tara Smith, PHARMD
• Rachel Stinespring Smyth, M.A. CCC-SLP
• Jarrett Wilson Southall, RPH
• Melissa Blanks Spaulding, M.S.CCC-SLP
• Margaret Stalls
• Holly Steg, LCMHCA
• Carolyn Steger, M.ED, LPA # 0794
• Elana Turner Stephens

• Assisted Living Facility in Louisburg, NC
• Providers in Louisburg, 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 25, 2017; 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.