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BROOKDALE MONROE SQUARE 1
NPI 1265597256
Assisted Living Facility in Monroe, NC

Active since December 27, 2006CLIA 34D2030062 · Waiver
918 FITZGERALD ST, MONROE, NC 28112(704) 225-0200(704) 238-9762 Get Directions Write a Review

NPPES record last updated: April 7, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Brookdale Monroe Square 1 NPPES

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

BROOKDALE MONROE SQUARE 1 (NPI 1265597256) is a healthcare organization registered as an assisted living facility in Monroe, North Carolina and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through September 20, 2027 and lists Joanne K Leskowicz, Senior Vice President, as its authorized official.

NPPES Registry Identity

NPI1265597256
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSOUTHERN ASSISTED LIVING, LLC.
Location Address918 FITZGERALD STMonroe, NC 28112-5683
Mailing Address6737 W Washington St, Suite 2300Milwaukee, WI 53214-5647
Phone(704) 225-0200
Fax(704) 238-9762
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 1265597256 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.
918 FITZGERALD ST, Monroe, NC 28112
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Other Names 1

Doing Business AsBrookdale Monroe Square 1

Other Identifiers 1

Medicaid7804071NC

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 34D2030062

Brookdale Monroe Square 1 · Monroe, NC
Active · expires Sep 20, 2027
CLIA Number34D2030062
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 21, 2025
Certificate Expiration DateSeptember 20, 2027
Laboratory DirectorAmie M. James
Laboratory Phone(704) 225-0200
Laboratory LocationBrookdale Monroe Square 1918 Fitzgerald Street, Monroe, NC 28112
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 1265597256. It was assigned to this organization in the NPPES registry on December 27, 2006. The provider is doing business as Brookdale Monroe Square 1.

Where is Southern Assisted Living, LLC. located?

Southern Assisted Living, LLC. is located at 918 Fitzgerald St, Monroe, NC 28112. The listed phone number is (704) 225-0200.

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 34D2030062) is associated with this NPI, valid through September 20, 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 Southern Assisted Living, LLC. was last updated on April 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.