Warren County Association for Retarded Citizens, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

WARREN COUNTY ASSOCIATION FOR RETARDED CITIZENS, INC

Practice address

100 Smoky LN
Vicksburg, MS 39180-5940

Phone

(601) 638-2761

Fax

(601) 638-2733

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kearney Waites, M.ED. LSW

Title

Director-Arc Programs

Phone

(601) 638-2761

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Warren County ARC Other name

Tax ID family

Midd West2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Warren County Assn.for Retarded Citizens, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Vicksburg, MS
  • NPI 1245604941
  NPD tax ID

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043335045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SMOKY LN",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805940",
            "telephone_number": "601-638-2761",
            "fax_number": "601-638-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SMOKY LN",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805940",
            "telephone_number": "601-638-2761",
            "fax_number": "601-638-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN COUNTY ASSOCIATION FOR RETARDED CITIZENS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAITES",
        "authorized_official_first_name": "KEARNEY",
        "authorized_official_title_or_position": "DIRECTOR-ARC PROGRAMS",
        "authorized_official_telephone_number": "601-638-2761",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED.  LSW"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770130",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warren County ARC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shannon Laiche Wallace, NP
• Lisa Wamsley, RPH
• April Ward
• Angela Warnock
• Warren County Assn.for Retarded Citizens, Inc.
• Warren Yazoo Mental Health Service
• Warren- Yazoo Mental Health Service
• Warren-Yazoo Mental Health Service
• Warren-Yazoo Mental Health Service, Inc.
• Gene Warren, M.D.

• Developmentally Disabled Services Day Training Agency in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Developmentally Disabled Services Day Training Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.