Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Manor Living Centers, LLC

Organization Assisted Living Facility · NPI 1619274644

Southern Manor Living Centers, LLC is an Assisted Living Facility in Fayetteville, Tennessee. Licensed in Tennessee. Registered with an NPI since 2011.

Licensed in
TN
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

115 Medical Center Blvd
Fayetteville, TN 37334-2689
Phone: (931) 433-5000
Fax: (931) 433-6908
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence ACL0000000215 (TN)

Record details

NPI number1619274644
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cheryl Pendergrass — Executive Director · (931) 433-5000
NPI enumeratedFebruary 28, 2011
Last updated in NPPESFebruary 28, 2011
Mailing address115 Medical Center Blvd, Fayetteville, TN 37334-2689

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