Sovran Senior Living, LLC
Assisted Living Facility in Mount Olive, NC. Organization (NPI-2).
NPI number1508134685
StatusActive
Last updated in NPPESJun 16, 2018
Details
- NPI
- 1508134685
- Entity type
- Organization (NPI-2)
- Legal business name
- Sovran Senior Living, LLC
- Organization subpart
- No
- Enumeration date
- Dec 5, 2011
- Last updated
- Jun 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
Other names
- Ssl Of Mount Olive Nc LLC (Other Name)
- Waylin Life Care Center (Doing Business As)
Practice location
600 Smith Chapel RdMount Olive, NC 28365-2632
Phone 919-658-6501 · Fax 919-658-6799
Mailing address
1400 Centrepark Blvd Ste 810West Palm Beach, FL 33401-7412
Phone 239-659-4900 · Fax 239-963-3410
Authorized official
Dorene M Ford
Director Of Mis
2396594900
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