WILLOWOOD DEVELOPMENTAL CENTER (NPI# 1174991855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174991855 |
| Entity Type | Organization |
| Organization Name | WILLOWOOD DEVELOPMENTAL CENTER |
| Practice Address |
1635 Boling St Jackson MS 39213-4418 |
| Practice Telephone | 6013660123 |
| Practice Fax Number | 6013660149 |
| Mailing Telephone | 6013660123 |
| Mailing Fax Number | 6013660149 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |
| Authorized Official Name | MR. CURTIS E. ALFORD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6013660123 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | WDC-PVS-WAC-DSA- | MS | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831243070 | Willowood Developmental Center | Physical Therapist | 1635 Boling St, Jackson, MS 39213-4418 | 2007-01-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WILLOWOOD DEVELOPMENTAL CENTER INC | 1635 Boling St, Jackson, MS 39213-4418 |
| Street Address |
1635 BOLING ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821188285 | Deborah G Monsour | Speech-Language Pathologist | 1635 Boling St, Jackson, MS 39213-4418 | 2006-10-13 |
| 1619599677 | Karen Jane Day | Registered Nurse | 1635 Boling St, Jackson, MS 39213-4418 | 2020-05-13 |
| 1942437595 | Whitney Herron Nesbit | Occupational Therapist | 1635 Boling St, Jackson, MS 39213-4418 | 2009-06-22 |
| 1225209489 | Kecia Spencer Ray | Specialist | 1635 Boling St, Jackson, MS 39213-4418 | 2008-03-17 |
| 1326219585 | Stephanie Pieroni Oliver | Speech-Language Pathologist | 1635 Boling St, Jackson, MS 39213-4418 | 2008-03-17 |
| 1831243070 | Willowood Developmental Center | Physical Therapist | 1635 Boling St, Jackson, MS 39213-4418 | 2007-01-23 |
| 1326199787 | Owen Mullen | Specialist/Technologist | 1635 Boling St, Jackson, MS 39213-4418 | 2007-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669037701 | Amanda Elizabeth Derousse | Day Training, Developmentally Disabled Services | 1527 Deerwood Dr, Jackson, MO 63755-4148 | 2019-05-03 |
| 1134617350 | Golden Moments Home Care, LLC | Day Training, Developmentally Disabled Services | 201 Airways Blvd, Jackson, TN 38301-5800 | 2018-04-24 |
| 1144752874 | Robert Zangrillo | Day Training, Developmentally Disabled Services | 7 Bailey Ct, Jackson, NJ 08527-4459 | 2017-03-31 |
| 1235679523 | Doris C. Bridges | Day Training, Developmentally Disabled Services | 3928 Allen Dr, Jackson, MS 39212-5379 | 2017-03-06 |
| 1366995110 | Senior Services, LLC | Day Training, Developmentally Disabled Services | 21 Northtown Dr, Jackson, MS 39211-3016 | 2016-07-28 |
| 1891064002 | Tennessee Personal Assistance, Inc | Day Training, Developmentally Disabled Services | 31b Bowling Dr, Jackson, TN 38305-6100 | 2011-12-16 |
| 1508150160 | Never Forgotten Ministries | Day Training, Developmentally Disabled Services | 1122 Fincherville Rd, Jackson, GA 30233-3433 | 2011-06-01 |
| 1952526774 | Sitters & More, Inc. | Day Training, Developmentally Disabled Services | 125 Stonebridge Blvd Ste A, Jackson, TN 38305-2159 | 2007-04-16 |
| 1710012000 | Lifetime Potentials, Inc. | Day Training, Developmentally Disabled Services | 43 Lj Lane, Jackson, KY 41339 | 2007-02-23 |
| 1902931314 | Madison Haywood County Developmental Services, Inc | Day Training, Developmentally Disabled Services | 38 Garland Dr, Jackson, TN 38305-3602 | 2007-02-23 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.