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BROOKDALE EDEN
NPI 1093870123
Assisted Living Facility in Eden, NC

Active since December 27, 2006CLIA 34D2017663 · Waiver
314 W KINGS HWY, EDEN, NC 27288(336) 623-1901(336) 623-5144 Get Directions Write a Review

NPPES record last updated: April 7, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Brookdale Eden NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKDALE EDEN (NPI 1093870123) is a healthcare organization registered as an assisted living facility in Eden, North Carolina and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through December 14, 2026 and lists Joanne K Leskowicz, Senior Vice President, as its authorized official.

NPPES Registry Identity

NPI1093870123
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSOUTHERN ASSISTED LIVING, LLC.
Location Address314 W KINGS HWYEden, NC 27288-5012
Mailing Address6737 W Washington St, Suite 2300Milwaukee, WI 53214-5647
Phone(336) 623-1901
Fax(336) 623-5144
Organization SubpartYesParent: Brookdale Senior Living Inc
Authorized OfficialJoanne K LeskowiczSenior Vice President · (414) 918-5000
Enumeration DateDecember 27, 2006
Last NPPES UpdateApril 7, 2021
NPPES CertifiedApril 7, 2021
✔ NPI 1093870123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
314 W KINGS HWY, Eden, NC 27288
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Other Names 1

Doing Business AsBrookdale Eden

Other Identifiers 1

Medicaid7803876NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2017663

Brookdale Eden · Eden, NC
Active · expires Dec 14, 2026
CLIA Number34D2017663
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 15, 2024
Certificate Expiration DateDecember 14, 2026
Laboratory DirectorCherie Melton
Laboratory Phone(336) 623-1901
Laboratory LocationBrookdale Eden314 W Kings Hwy, Eden, NC 27288
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Assisted Living, LLC.'s NPI number?

The NPI number for Southern Assisted Living, LLC. is 1093870123. It was assigned to this organization in the NPPES registry on December 27, 2006. The provider is doing business as Brookdale Eden.

Where is Southern Assisted Living, LLC. located?

Southern Assisted Living, LLC. is located at 314 W Kings Hwy, Eden, NC 27288. The listed phone number is (336) 623-1901.

What is Southern Assisted Living, LLC.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Southern Assisted Living, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2017663) is associated with this NPI, valid through December 14, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Assisted Living, LLC. was last updated on April 7, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.