COTTONWOOD MANOR II (NPI# 1417127895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417127895 |
| Entity Type | Organization |
| Organization Name | COTTONWOOD MANOR II |
| Other Organization Name | MAGNOLIA MANOR |
| Practice Address |
410 E First St Forest MS 39074-4204 |
| Mailing Address |
41 South Hall Rd 410 East First Street Morton MS 39117 |
| Practice Telephone | 6014694389 |
| Mailing Telephone | 6017328473 |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |
| Authorized Official Name | MRS. PAULETTE BUTLER (OWNER) |
| Authorized Official Telephone | 6017328473 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 954 | MS | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| magnolia Manor | Doing Business As Name - Organization |
| Street Address |
410 E FIRST ST |
| City | FOREST |
| State | MS |
| Zip Code | 39074-4204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841755865 | Nissi LLC | Assisted Living Facility | 410 E First St, Forest, MS 39074-4204 | 2019-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467095927 | Tamatha Nicole Owen | Nurse Practitioner | 1061 Highway 35 S, Forest, MS 39074 | 2019-10-28 |
| 1154687838 | Region Ten Commission On Mental Health | Clinic/Center | 13682 Hwy 80 West, Forest, MS 39074 | 2012-04-06 |
| 1053567636 | Cathy G Cooper | Physical Therapist | 813 West 3rd Street, Forest, MS 39074 | 2008-08-14 |
| 1487866158 | Terry Ann Meadows | Clinic/Center | 330 North Broad St, Forest, MS 39074 | 2007-05-04 |
| 1770702144 | Randy K Reynolds | Dentist | 208 West 3rd Street, Forest, MS 39074 | 2007-04-24 |
| 1215067293 | John B. Smith, Jr. Dmd, Pa | Dentist | 1040 Highway 35 South, Drawer 30, Forest, MS 39074 | 2007-03-07 |
| 1225189244 | Douglas F Harvel, Jr | Dentist | 1040 Highway 35 S, Forest, MS 39074 | 2007-01-16 |
| 1861542433 | Forest Dental Practice Pllc | Dentist | Po Drawer 30, Forest, MS 39074 | 2007-01-12 |
| 1306996970 | John B Smith Jr. | Dentist | 1040 Hwy 35 South, Forest, MS 39074 | 2007-01-12 |
| 1295821072 | Buddy Lee Eady | Chiropractor | 500 East 3rd St., Forest, MS 39074 | 2006-10-05 |
| Find all providers in zip 39074 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215558747 | Waymaker Enterprises, LLC | Assisted Living Facility | 204 Bradfield Rd, Madison, MS 39110-7035 | 2020-05-06 |
| 1417508110 | Maxine Delores Harris | Assisted Living Facility | 104 Martin Luther King Blvd, Arcola, MS 38722 | 2019-09-24 |
| 1548819733 | Snh Omiss Tenant LLC | Assisted Living Facility | 1488 Belk Blvd, Oxford, MS 38655-5356 | 2019-09-10 |
| 1457900649 | Snh Omiss Tenant LLC | Assisted Living Facility | 108 Clarington Dr, Southaven, MS 38671-5640 | 2019-09-10 |
| 1972152619 | The Claiborne At Adelaide | Assisted Living Facility | 74 Claiborne Way, Starkville, MS 39759-8544 | 2019-09-05 |
| 1992369102 | James Wilson | Assisted Living Facility | 15986 W Main St, Louisville, MS 39339-2636 | 2019-04-24 |
| 1023519766 | The Blake At Oxford | Assisted Living Facility | 110 Ed Perry Blvd, Oxford, MS 38655-3452 | 2018-02-27 |
| 1194224873 | Barnes Crossing Retirement Community LLC | Assisted Living Facility | 1090 County Road 811, Saltillo, MS 38866-7304 | 2018-02-07 |
| 1649782202 | Garden Hill Assisted Living | Assisted Living Facility | 2082 Yorkville Rd E, Columbus, MS 39702-9406 | 2017-11-03 |
| 1891228581 | Magnolia Gardens Assisted Living | Assisted Living Facility | 303 East Ivy, Ellisville, MS 39437 | 2017-04-10 |
| Find all providers with the same taxonomy | ||||
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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.