Inner Peace Living, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

INNER PEACE LIVING, INC

Practice address

1174 Old Industrial Rd
McComb, MS 39648-9407

Phone

(601) 600-2170

NPI assigned

Mar 27, 2023

Last updated

Mar 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Latreshia Martin, RN,BSN

Title

Owner/Ceo

Phone

(769) 217-0209

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1083317168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 OLD INDUSTRIAL RD",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396489407",
            "telephone_number": "769-217-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 OLD INDUSTRIAL RD",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396489407",
            "telephone_number": "601-600-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER PEACE LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "LATRESHIA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "769-217-0209",
        "authorized_official_credential": "RN,BSN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in McComb, MS
• Providers in McComb, MS by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.