National Provider Identifier Database

SOUTHERN ASSISTED LIVING LLC
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.


Contact Information

SOUTHERN ASSISTED LIVING, LLC.
2931 VANCE STREET
REIDSVILLE, NC27320
Phone: 336-634-0002
Fax: 336-634-2240
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X

* Indicates primary specialty

NPI Profile & details for SOUTHERN ASSISTED LIVING, LLC.

NPI Number 1861558728
Legal business name
LBN
SOUTHERN ASSISTED LIVING, LLC.
Authorized official JOANNE LESKOWICZ - (SENIOR VICE PRESIDENT)
Entity Organization
Organization subpart Yes
Enumeration date 12/28/2006
Last updated 04/08/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • NC Medicaid: 7803325

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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