KIDS' KASTLE GLUCKSTADT (NPI# 1962041798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962041798 |
| Entity Type | Organization |
| Organization Name | KIDS' KASTLE GLUCKSTADT |
| Practice Address |
112 Westfalen Drive Canton MS 39046 |
| Mailing Address |
115 Aulenbrock Dr Ste A Canton MS 39046-7036 |
| Practice Telephone | 6014990167 |
| Practice Fax Number | 6014990294 |
| Mailing Telephone | 6014990167 |
| Mailing Fax Number | 6014990294 |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2019-12-26 |
| Authorized Official Name | MRS. JETUWAN M BROWN (MANAGING OFFICER) |
| Authorized Official Telephone | 6012786710 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251J00000X | Nursing Care | Agencies | ||
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
Nursing & Custodial Care Facilities |
| Street Address |
112 WESTFALEN DRIVE |
| City | CANTON |
| State | MS |
| Zip Code | 39046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858053 | Pediatric Haven | Skilled Nursing Facility | 112 Westfalen Drive, Canton, MS 39046 | 2019-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932743176 | Stacey Elizabeth Aldridge | Social Worker | 210 E Peace Street, Canton, MS 39046 | 2019-10-31 |
| 1881245736 | Mildred Loving | Technician | 323 Shady Lane, Canton, MS 39046 | 2019-09-23 |
| 1295384683 | Betty Bass | Technician | 693 Miggins Road, Canton, MS 39046 | 2019-09-09 |
| 1972081644 | Charles Brayden Jones | Physical Therapist | 276 Nissan Pkwy Ste 400, Canton, MS 39046 | 2018-08-03 |
| 1013436062 | Andrew J Breland | Counselor | 210 E Peace St, Canton, MS 39046 | 2017-09-11 |
| 1801318290 | Mississippi Enjoy Breastfeeding Shalom Resource Center | Clinic/Center | 343 Smith Street, Canton, MS 39046 | 2017-07-07 |
| 1619362977 | Shameca Hudson | Nurse Practitioner | 274 Cobbville Dr E, Canton, MS 39046 | 2015-04-03 |
| 1144644386 | Margaret Reimers Beckwith | Chiropractor | 124 Links Drive, I-103, Canton, MS 39046 | 2014-02-07 |
| 1053753194 | Tanya Linette Calhoun | Nurse Practitioner | 1171 Hart Street, Canton, MS 39046 | 2013-07-17 |
| 1235470139 | First Step Community Care LLC | Chore Provider | 2633 South Liberty St, Ste B, Canton, MS 39046 | 2013-03-04 |
| Find all providers in zip 39046 | ||||
| Taxonomy Code | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858053 | Pediatric Haven | Skilled Nursing Facility | 112 Westfalen Drive, Canton, MS 39046 | 2019-12-20 |
| 1801288915 | Renaissance Care Center, Inc | Skilled Nursing Facility | 1675 E Ash St, Canton, IL 61520-1510 | 2015-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588104814 | Jackson County Pediatric Extended Care LLC | Skilled Nursing Facility | 2025 Jackson Ave, Pascagoula, MS 39567-4427 | 2017-03-06 |
| 1801256318 | Caring Hands Ppec of Vicksburg, LLC | Skilled Nursing Facility | 3419 Wisconsin Ave, Vicksburg, MS 39180-5330 | 2016-02-25 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1609259936 | Meridian Pediatric Extended Care LLC | Skilled Nursing Facility | 3850 Highway 45 N, Meridian, MS 39301-1517 | 2015-07-06 |
| 1093198731 | Caring Hands Prescribed Pediatric | Skilled Nursing Facility | 371 Towne Center Pl, Ridgeland, MS 39157-4833 | 2015-06-30 |
| 1538249792 | Memorial Hospice Inc | Skilled Nursing Facility | 600 Ohio Street, Clarksdale, MS 38614 | 2006-10-16 |
| 1639606940 | Pediatrust Columbus, LLC | Skilled Nursing Facility | 306 Hospital Dr, Columbus, MS 39705-1935 | 2017-05-17 |
| 1437523511 | Delta Pediatric Care | Skilled Nursing Facility | 526 Fairview Ave, Greenville, MS 38701-5401 | 2015-11-30 |
| 1891107298 | Gulf Coast Pediatric Care LLC | Skilled Nursing Facility | 1285 Spring St, Gulfport, MS 39507-3423 | 2014-05-20 |
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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.