LSA ELMS AT TANGLEWOOD INC. NPI 1962648543

NPI Information

  • NPI: 1962648543
  • Provider Name: LSA ELMS AT TANGLEWOOD, INC.
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: ELMS AT TANGLEWOOD
  • CLIA Number: 34D2017454
  • Address: 3750 HARPER RD
    CLEMMONS, NC
    ZIP 27012
  • Phone: (336) 766-2131

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NPI Details

LSA ELMS AT TANGLEWOOD, INC. is an assisted living facility in Clemmons, NC. The provider is 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. LSA ELMS AT TANGLEWOOD, INC. NPI is 1962648543. The provider is registered as an organization entity type.
The provider Is Doing Business As Elms At Tanglewood.

The provider's business location address is:

3750 HARPER RD
CLEMMONS, NC
ZIP 27012-682
Phone: (336) 766-2131
Fax: (336) 766-2160

The provider's authorized official is Deborah Ann Mathis .
The authorized official title is Coo and has the following contact phone number (704) 637-2870.

The CLIA number assigned to this NPI record is 34D2017454 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2009 and was last updated on 1/2/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311500000XAlzheimer Center (Dementia Center)HAL034085NORTH CAROLINANo
2310400000XAssisted Living FacilityHAL034085NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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