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Organization

SOUTHMINSTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARY COOPER RN NAA (ADMINISTRATOR)
(704) 551-7118
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
0414
NC
311500000X
Alzheimer Center (Dementia Center)
Primary
0414
NC
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
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