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SOUTH HAVEN LONG TERM CARE
NPI 1518085935
Assisted Living Facility in Gastonia, NC

Active since March 26, 2007
916 S MARIETTA ST, GASTONIA, NC 28054(704) 830-1101 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About South Haven Long Term Care NPPES

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

SOUTH HAVEN LONG TERM CARE (NPI 1518085935) is a healthcare organization registered as an assisted living facility in Gastonia, North Carolina and active in the NPI registry since March 2007. The organization lists Holly Gause, Administrator, as its authorized official.

NPPES Registry Identity

NPI1518085935
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLUBY-JAY INC
Location Address916 S MARIETTA STGastonia, NC 28054-5405
Mailing AddressPo Box 1678Clemmons, NC 27012-1678 · (336) 998-5001 · Fax (336) 998-5470
Phone(704) 830-1101
Organization SubpartNo
Authorized OfficialHolly GauseAdministrator · (704) 830-1101
Enumeration DateMarch 26, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1518085935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in NC · HAL-036-005
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.
916 S MARIETTA ST, Gastonia, NC 28054
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Other Names 1

Doing Business AsSouth Haven Long Term Care

Other Identifiers 1

Medicaid7801358NC

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.

GASTON AREA LUTHERAN FOUNDATION INC.
Assisted Living Facility
916 S MARIETTA ST
GASTONIA, NC 28054
Gaston County (704) 864-3249
HERITAGE OAKS LLC
Assisted Living Facility
916 S MARIETTA ST
GASTONIA, NC 28054
Gaston County (980) 505-4427
DELTA HEALTHCARE MANAGEMENT
Assisted Living Facility
916 S MARIETTA ST
GASTONIA, NC 28054
Gaston County (704) 864-3249

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 Luby-Jay Inc's NPI number?

The NPI number for Luby-Jay Inc is 1518085935. It was assigned to this organization in the NPPES registry on March 26, 2007. The provider is doing business as South Haven Long Term Care.

Where is Luby-Jay Inc located?

Luby-Jay Inc is located at 916 S Marietta St, Gastonia, NC 28054. The listed phone number is (704) 830-1101.

What is Luby-Jay Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Luby-Jay Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.