# SOUTHMINSTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255596979
- **Authorized official:** MRS. MARY COOPER RN NAA (ADMINISTRATOR)
- **Authorized official phone:** (704) 551-7118

## Contact information

- **Practice address:** 8919 PARK RD, CHARLOTTE, NC 28210
- **Practice address phone:** (704) 551-6800
- **Practice address fax:** (704) 551-6868
- **Mailing address:** 8919 PARK RD, CHARLOTTE, NC 28210
- **Mailing address phone:** (704) 551-6800
- **Mailing address fax:** (704) 551-6868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 0414 | NC | — |
| 311500000X | Alzheimer Center (Dementia Center) | 0414 | NC | Yes |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 0414 | NC | — |
| 314000000X | Skilled Nursing Facility | 0414 | NC | — |

## Other

- **Enumeration date:** 07/22/2008
- **Last updated:** 07/22/2008