Co-Med Adult Day Care Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

05521743 Issued in MS

Legal business name

CO-MED ADULT DAY CARE CENTER

Practice address

3249 N Church Ave
Louisville, MS 39339-2072

Phone

(662) 773-7066

Fax

(662) 773-2677

NPI assigned

Mar 4, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Tomekia Carter

Title

Director

Phone

(662) 773-7066

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1033501739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 N CHURCH AVE",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393392072",
            "telephone_number": "662-773-7066",
            "fax_number": "662-773-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 N CHURCH AVE",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393392072",
            "telephone_number": "662-773-7066",
            "fax_number": "662-773-2677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525C N Church Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "MS",
            "postal_code": "393392014",
            "country_code": "US",
            "telephone_number": "662-773-7066",
            "fax_number": "662-773-2677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CO-MED ADULT DAY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-04",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "TOMEKIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "662-773-7066",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MS",
            "license": "05521743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05521743",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.