MAJESTIC ESTATES LLC. (NPI# 1932525714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932525714 |
| Entity Type | Organization |
| Organization Name | MAJESTIC ESTATES LLC. |
| Practice Address |
511 N Broad St Forest MS 39074-3511 |
| Mailing Address |
Po Box 1442 Forest MS 39074-0442 |
| Practice Telephone | 6014052116 |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-03-17 |
| Authorized Official Name | PHAREN NELSON (OWNER) |
| Authorized Official Telephone | 6014052116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MS | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | STATE ID | 1029044 | 01 |
| Street Address |
511 N BROAD ST |
| City | FOREST |
| State | MS |
| Zip Code | 39074-3511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316426166 | Divine Transit, LLC | Non-emergency Medical Transport (VAN) | 511 N Broad St, Forest, MS 39074-3511 | 2018-08-13 |
| 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 | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336507284 | Lapearls Residential and Private Care Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2634 E Lake Blvd Apt 9-9, Robinsonville, MS 38664-8916 | 2016-02-07 |
| 1912383779 | Mississippi Health Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 W Amite St, Jackson, MS 39201-1203 | 2015-08-04 |
| 1053742684 | Building Futures, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 220 Mcdowell Park Cir, Jackson, MS 39204-4317 | 2013-12-08 |
| 1649552829 | Miles Cororation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3959 Highway 468 W, Pearl, MS 39208-9001 | 2011-09-14 |
| 1376840058 | Mississippi Adolescent Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 760 Brookman Drive Extension, Brookhaven, MS 39601-2340 | 2011-02-16 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1346329935 | Boswell Regional Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Simpson Old Hwy 49 North, Magee, MS 39111-0128 | 2006-11-03 |
| 1831680792 | Gulf Gardens Residential and Community Living LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 460 Briarwood Dr Ste 400, Jackson, MS 39206-3062 | 2018-05-25 |
| 1023367455 | Lucy B Hodges Rn Fpnp Pllc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1303 River Rd, Greenwood, MS 38930-4029 | 2012-08-30 |
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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.