NPIMap

Organization Active NPI

Willowood Developmental Center

  • Developmentally Disabled Services Day Training Agency
  • Jackson, MS
National Provider Identifier
1174991855
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
WDC-PVS-WAC-DSA-01 Issued in MS
Legal business name
WILLOWOOD DEVELOPMENTAL CENTER
Practice address
1635 Boling St
Jackson, MS 39213-4418
Phone
(601) 366-0123
Fax
(601) 366-0149
NPI assigned
Sep 11, 2015
Last updated
Sep 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Authorized official

Name
Mr. Curtis E. Alford
Title
Executive Director
Phone
(601) 366-0123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X WDC-PVS-WAC-DSA-01 MS Primary

Addresses

Primary practice location

1635 Boling St
Jackson, MS 39213-4418

Mailing address

1635 Boling St
Jackson, MS 39213-4418
Phone (601) 366-0123

National Provider Directory

National Provider Directory
Tax ID family
Willowood Developmental Center2 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.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1174991855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 BOLING ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134418",
            "telephone_number": "601-366-0123",
            "fax_number": "601-366-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 BOLING ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134418",
            "telephone_number": "601-366-0123",
            "fax_number": "601-366-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWOOD DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "ALFORD",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-366-0123",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MS",
            "license": "WDC-PVS-WAC-DSA-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.