WCRL, LLC (NPI# 1780758904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780758904 |
| Entity Type | Organization |
| Organization Name | WCRL, LLC |
| Other Organization Name | WILLOW CREEK RETIREMENT CENTER |
| Practice Address |
49 Willow Creek Ln Jackson MS 39272-9255 |
| Mailing Address |
Po Box 2712 Ridgeland MS 39158-2712 |
| Practice Telephone | 6018634201 |
| Practice Fax Number | 6018634202 |
| Mailing Telephone | 6018532667 |
| Mailing Fax Number | 6018532116 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-02-20 |
| Authorized Official Name | MR. DAVID ROTOLO (MEMBER) |
| Authorized Official Telephone | 6018532667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 926 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00230143 | 05 |
| Other Name | Type Code |
|---|---|
| Willow Creek Retirement Center | Doing Business As Name - Organization |
| Street Address |
49 WILLOW CREEK LN |
| City | JACKSON |
| State | MS |
| Zip Code | 39272-9255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649893363 | Prestige Dental Care | Dentist | 7138 S Siwell Road, Byram, MS 39272 | 2020-05-28 |
| 1093204158 | Primary Family Medical Clinic | Nurse Practitioner | 100 Marker Place Dr. Ste D, Byram, MS 39272 | 2018-05-04 |
| 1457869190 | Lakisha Ann Mcmorris | Adult Companion | 300 Byram Drive, Apt 51d, Byram, MS 39272 | 2018-01-16 |
| 1639692908 | Quintin Todd Julius, Pllc | Dentist | 6745 S. Siwell Rd., Suite 210, Byram, MS 39272 | 2017-07-19 |
| 1134649395 | Helping Hands Service LLC | Home Health | 1402 Siwell Rd Suite 110, Byram, MS 39272 | 2017-06-20 |
| 1760916050 | Delivery Me, LLC | Non-emergency Medical Transport (VAN) | 5210 Brookleigh Drive, Byram, MS 39272 | 2017-04-13 |
| 1962893396 | Rebecca Holley | Speech-Language Pathologist | 7213 S Siwell Road, Byram, MS 39272 | 2015-02-06 |
| 1144665738 | Providence Healthcare of Ms | Nursing Care | 6735 I-55 South Frontage Road, Suite 2-a, Byram, MS 39272 | 2013-05-08 |
| 1568742146 | Deandre Monique Carr | Optometrist | 131 Handley Boulevard, Byram, MS 39272 | 2011-08-26 |
| 1063690022 | Physical Rehabilitation Management | Physical Therapist | 128 Byram Center Drive, Jackson, MS 39272 | 2008-02-01 |
| Find all providers in zip 39272 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326348897 | Laurie L. Mcbride | Skilled Nursing Facility | 180 W University Pkwy Ste H, Jackson, TN 38305-1612 | 2010-10-29 |
| 1407179039 | Caring Hands Community Services Inc | Skilled Nursing Facility | 3318 Longwood Drive, Jackson, MS 39212 | 2010-03-10 |
| 1568791804 | North Street Healthcare LLC | Skilled Nursing Facility | 865 North St, Jackson, MS 39202-3020 | 2009-12-16 |
| 1679712665 | West Tennessee Transitional Care Inc | Skilled Nursing Facility | 597 West Forest Ave, Jackson, TN 38301 | 2009-02-13 |
| 1285802652 | Trilogy Healthcare of Jackson, LLC | Skilled Nursing Facility | 703 Robinson Road, Jackson, MI 49203-2538 | 2008-02-19 |
| 1174732333 | Louisiana War Veterans Home | Skilled Nursing Facility | 4739 Highway 10, Jackson, LA 70748 | 2007-05-22 |
| 1760521256 | Omni Visions, Inc | Skilled Nursing Facility | 50 Directors Row, Jackson, TN 38305 | 2007-02-05 |
| 1326197211 | Cottage Grove Nursing Home, Lp | Skilled Nursing Facility | 1116 Forest Ave, Jackson, MS 39206-3216 | 2007-01-09 |
| 1164597688 | Countryside Care Center, Inc. | Skilled Nursing Facility | 2121 Robinson Rd, Jackson, MI 49203-3658 | 2006-11-21 |
| 1073687083 | Chadwick Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 1900 Chadwick Dr, Jackson, MS 39204-3406 | 2006-11-20 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on WCRL, LLC.
| 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.