BROOKDALE WEDDINGTON PARK
NPI 1386700284
Assisted Living Facility in Matthews, NC

Active since December 28, 2006CLIA 34D2026835 · Waiver
2404 PLANTATION CENTER DR, MATTHEWS, NC 28105(704) 847-9477(704) 814-9869 Get Directions Write a Review

NPPES record last updated: April 8, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Brookdale Weddington Park NPPES

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

BROOKDALE WEDDINGTON PARK (NPI 1386700284) is a healthcare organization registered as an assisted living facility in Matthews, North Carolina and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through July 11, 2027 and lists Joanne K Leskowicz, Senior Vice President, as its authorized official.

NPPES Registry Identity

NPI1386700284
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSOUTHERN ASSISTED LIVING, LLC.
Location Address2404 PLANTATION CENTER DRMatthews, NC 28105-5299
Mailing Address6737 W Washington St, Suite 2300Milwaukee, WI 53214-5647
Fax(704) 814-9869
Organization SubpartYesParent: Brookdale Senior Living Inc
Authorized OfficialJoanne K LeskowiczSenior Vice President · (414) 918-5000
Enumeration DateDecember 28, 2006
Last NPPES UpdateApril 8, 2021
NPPES CertifiedApril 8, 2021
NPI 1386700284 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.

2404 PLANTATION CENTER DR, Matthews, NC 28105

Other Names 1

Doing Business AsBrookdale Weddington Park

Other Identifiers 1

Medicaid7803886NC

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 34D2026835

Southern Assisted Living, LLC Dba Brookdale Weddington Park · Matthews, NC
Active · expires Jul 11, 2027
CLIA Number34D2026835
Laboratory TypeAssisted Living Facility
Certificate Effective DateJuly 12, 2025
Certificate Expiration DateJuly 11, 2027
Laboratory DirectorJennifer Fitchett
Laboratory Phone(704) 847-9477
Laboratory LocationSouthern Assisted Living, LLC Dba Brookdale Weddington Park2404 Plantation Center Drive, Matthews, NC 28105
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
2404 PLANTATION CENTER DR
MATTHEWS, NC 28105
Physical Therapist
2404 PLANTATION CENTER DR
MATTHEWS, NC 28105
Assisted Living Facility
2404 PLANTATION CENTER DR
MATTHEWS, NC 28105

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 1386700284. It was assigned to this organization in the NPPES registry on December 28, 2006. The provider is doing business as Brookdale Weddington Park.

Where is Southern Assisted Living, LLC. located?

Southern Assisted Living, LLC. is located at 2404 Plantation Center Dr, Matthews, NC 28105. The listed phone number is (704) 847-9477.

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 34D2026835) is associated with this NPI, valid through July 11, 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 8, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.