Methodist Home Road Assisted Living

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

METHODIST HOME ROAD ASSISTED LIVING

Practice address

4560 Methodist Home Rd
Jackson, MS 39213-4201

Phone

(769) 257-7232

Fax

(769) 257-7745

NPI assigned

Jun 19, 2014

Organization subpart

No

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

Authorized official

Name

Kiara Lashae JohnsonNPI 1134533896

Title

Manager

Phone

(601) 918-6415

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Kiara Lashae Johnson

  • Respite Care
  • Jackson, MS
  • NPI 1134533896
  NPD (past) Authorized official

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1215341979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 METHODIST HOME RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 METHODIST HOME RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134201",
            "telephone_number": "769-257-7232",
            "fax_number": "769-257-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HOME ROAD ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIARA",
        "authorized_official_middle_name": "LASHAE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-918-6415"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Max Metcalf, D.D.S.
• Sallie Gardner Metcalf, OTR/L
• Methodist Children's Homes
• Methodist Children's Homes
• Methodist Children's Homes
• Methodist Home Road Living Center
• Methodist Pain Management, LLC
• Marisa Carmen Metildi, MD
• Metro Dental Inc
• Metro Pharmacy Inc

• Mental Illness Community Based Residential Treatment Facility in Jackson, MS
• Providers in Jackson, MS by specialty
• Mental Illness Community Based Residential Treatment Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.