SHIRLEY'S ASSISTED LIVING (NPI# 1316227580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316227580 |
| Entity Type | Organization |
| Organization Name | SHIRLEY'S ASSISTED LIVING |
| Practice Address |
1000 Bb King Rd Indianola MS 38751-3606 |
| Practice Telephone | 6628873000 |
| Practice Fax Number | 6628873500 |
| Mailing Telephone | 6628873000 |
| Mailing Fax Number | 6628873500 |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2011-08-19 |
| Authorized Official Name | MRS. SHIRLEY MONROE (OWNER) |
| Authorized Official Telephone | 6628873000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
1014 | MS | Nursing & Custodial Care Facilities |
| Street Address |
1000 BB KING RD |
| City | INDIANOLA |
| State | MS |
| Zip Code | 38751-3606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851671952 | Shirley Monroe | Technician | 1000 Bb King Rd, Indianola, MS 38751-3606 | 2011-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649781253 | Greater Hearts Adult Daycare | Clinic/Center | 124 Curtis Street, Indianola, MS 38751 | 2017-10-23 |
| 1083139505 | Quality Family Care LLC | Nurse Practitioner | 310 Hwy 82 West, Suite D, Indianola, MS 38751 | 2017-08-05 |
| 1932641800 | Creative Image Personal Care Services LLC | Respite Care | 503 Hwy 82 East, Indianola, MS 38751 | 2016-11-09 |
| 1225580442 | St. John's Respite Care Services, LLC | In Home Supportive Care | 517 East Street, Indianola, MS 38751 | 2016-11-04 |
| 1992163588 | Rona Kaye Huey | Nurse Practitioner | 310 Highway 82 W Ste D, Indianola, MS 38751 | 2016-02-10 |
| 1952641201 | Julia R. Hill, Dmd, Pa | Dentist | 104 W. Gresham St., Indianola, MS 38751 | 2013-02-25 |
| 1649463977 | Kenneth C Beal Jr. | Dentist | 913 B.b. King Road, Indianola, MS 38751 | 2007-08-21 |
| 1922136688 | Lloyd Leon Patton Jr. | Pharmacist | 903 Highway 82 East, Building G, Indianola, MS 38751 | 2007-03-02 |
| 1770623506 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | 110 East Baker Street, Indianola, MS 38751 | 2007-02-08 |
| 1548311525 | Quality In Home Services Inc | Homemaker | 108 Martin Luther King, Indianola, MS 38751 | 2007-01-16 |
| Find all providers in zip 38751 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679134183 | Sunset Residential Center LLC | Assisted Living Facility | 20114b Highway 18, Hermanville, MS 39086-9747 | 2019-06-25 |
| 1740756758 | Alfred Conway Porter | Assisted Living Facility | 3201 Hollywood Ave, Jackson, MS 39213-6754 | 2018-10-17 |
| 1427535491 | Carnell Kitchens | Assisted Living Facility | 585 E Beasley Rd, Jackson, MS 39206-3044 | 2018-07-23 |
| 1831556331 | Falcon Crest Personal Care Assisted Living | Assisted Living Facility | 4 Falcon Ln, Hattiesburg, MS 39401-9350 | 2016-01-28 |
| 1780096586 | Rest Haven | Assisted Living Facility | 686 County Road 370, Enterprise, MS 39330-9727 | 2014-05-28 |
| 1811232135 | Fondren Cove Relay, Inc. | Assisted Living Facility | 4520 N State St, Jackson, MS 39206-5307 | 2012-11-28 |
| 1376893842 | In Loving Arms LLC | Assisted Living Facility | 83 White Chapel Road, Carriere, MS 39426-8778 | 2012-09-12 |
| 1841755865 | Nissi LLC | Assisted Living Facility | 410 E First St, Forest, MS 39074-4204 | 2019-02-04 |
Please comment or provide details below to improve the information on SHIRLEY'S ASSISTED LIVING.
| 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.