# STANLEY TOTAL LIVING CENTER, INC

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

## Provider details

- **NPI number:** 1407843097
- **Authorized official:** MRS. JENNIFER DEFELICE RN (ADMINISTRATOR)
- **Authorized official phone:** (704) 263-1986

## Contact information

- **Practice address:** 514 OLD MOUNT HOLLY RD, STANLEY, NC 28164-2191
- **Practice address phone:** (704) 263-1986
- **Practice address fax:** (704) 263-8959
- **Mailing address:** PO BOX 489, STANLEY, NC 28164-0489
- **Mailing address phone:** (704) 263-1986
- **Mailing address fax:** (704) 263-8959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | NH0386 | NC | — |
| 311ZA0620X | Adult Care Home Facility | NH0386 | NC | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH0386 | NC | — |
| 314000000X | Skilled Nursing Facility | NH0386 | NC | Yes |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 11/19/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0086C | PROVIDER NUMBER | NC |
| 05 | — | 3405264 | — | NC |