NPIMap

Organization Active NPI

Warren County Assn.for Retarded Citizens, Inc.

Doing business as MIDD West

  • Developmentally Disabled Services Day Training Agency
  • Vicksburg, MS
National Provider Identifier
1245604941
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
MIDD-AGENCY Issued in MS
Legal business name
WARREN COUNTY ASSN.FOR RETARDED CITIZENS, INC.
Doing business as
MIDD West
Practice address
100 Smokey Lane
Vicksburg, MS 39180
Phone
(601) 638-2761
Fax
(601) 638-2733
NPI assigned
Nov 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Authorized official

Name
Mr. Kearney B Waites
Title
Program Director
Phone
(601) 638-2761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X MIDD-AGENCY MS Primary

Addresses

Primary practice location

100 Smokey Lane
Vicksburg, MS 39180

Mailing address

100 Smokey Lane
Vicksburg, MS 39180
Phone (601) 638-2761

Other names 1

  • MIDD West Doing business as

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1245604941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SMOKEY LANE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "39180",
            "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 SMOKEY LANE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "39180",
            "telephone_number": "601-638-2761",
            "fax_number": "601-638-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN COUNTY ASSN.FOR RETARDED CITIZENS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "WAITES",
        "authorized_official_first_name": "KEARNEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "601-638-2761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MS",
            "license": "MIDD-AGENCY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDD West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.