BROOKDALE PLACE OF SOUTH CHARLOTTE
NPI 1124451026
Assisted Living Facility in Charlotte, NC
About Brookdale Place Of South Charlotte NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROOKDALE PLACE OF SOUTH CHARLOTTE (NPI 1124451026) is a healthcare organization registered as an assisted living facility in Charlotte, North Carolina and active in the NPI registry since August 2013. The organization holds a CLIA Waiver certificate valid through March 27, 2027 and lists Mark Ohlendorf, Co-president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 34D2022073
Brookdale Place Of South Charlotte · Charlotte, NCOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Brookdale Place Of South Charlotte, LLC's NPI number?
The NPI number for Brookdale Place Of South Charlotte, LLC is 1124451026. It was assigned to this organization in the NPPES registry on August 14, 2013. The provider is doing business as Brookdale Place Of South Charlotte.
Where is Brookdale Place Of South Charlotte, LLC located?
Brookdale Place Of South Charlotte, LLC is located at 5515 Rea Rd, Charlotte, NC 28226. The listed phone number is (704) 544-2094.
What is Brookdale Place Of South Charlotte, LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Brookdale Place Of South Charlotte, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D2022073) is associated with this NPI, valid through March 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Brookdale Place Of South Charlotte, LLC was last updated on August 14, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Brookdale Place Of South Charlotte · NPI 1124451026
Assisted Living Facility organization in Charlotte, North Carolina. Organization record, active in the CMS NPPES registry since August 14, 2013.
## Identity
- **NPI:** 1124451026 (Entity type: Organization)
- **Enumerated:** August 14, 2013
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Legal business name:** Brookdale Place Of South Charlotte, Llc
- **Organization subpart:** No
- **Authorized official:** Mark Ohlendorf, CO-PRESIDENT
## Practice location
- **Address:** 5515 REA RD, Charlotte, NC 28226-3446
- **Phone:** (704) 544-2094
## Record status
- **NPPES last updated:** August 14, 2013
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1124451026) · Data from the CMS NPPES public registry.