Southern Manor Living Centers, LLC
NPI 1619274644ActiveOrganization· Assisted Living Facility· Fayetteville, TN
Assisted Living Facility in Fayetteville, Tennessee, registered in NPPES in February 2011. The authorized official on file is Cheryl Pendergrass, MSN, Executive Director.
Overview
| NPI | 1619274644 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 28, 2011 |
| Last updated in NPPES | Feb 28, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | ACL0000000215 | TN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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