Organization · Type 2 NPI

Sovran Senior Living, LLC

Assisted Living Facility · Mount Olive, NC

NPI number 1508134685 Active

Practice location

600 Smith Chapel Rd
Mount Olive, NC 28365-2632

Call (919) 658-6501 Map

Fax (919) 658-6799

Mailing address

1400 Centrepark Blvd Ste 810
West Palm Beach, FL 33401-7412

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	None listed

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.

NPI record

NPI: 1508134685
Entity type: Organization (Type 2)
Issued: Dec 5, 2011
Last updated: Jun 16, 2018
Status: Active

Other names

<unavail>
Waylin Life Care Center · doing business as
SSL of Mount Olive NC LLC · other name
SSL of Mount Olive NC LLC · other name

Authorized official

Ms. Dorene M Ford
Director of Mis
(239) 659-4900

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1508134685

Sovran Senior Living, LLC's National Provider Identifier is 1508134685, issued on Dec 5, 2011. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Mount Olive, NC. The record was last updated on Jun 16, 2018.