Senior Care Centers of Mississippi, LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

SENIOR CARE CENTERS OF MISSISSIPPI, LLC

Practice address

6250 Old Canton Rd
Suite 140
Jackson, MS 39211-2946

Phone

(601) 956-7794

Fax

(601) 206-8094

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Craig O Mehnert

Title

Cfo

Phone

(215) 642-6600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baptist Adult Day Health Services of N. Jackson Doing business as

Tax ID family

Baptist Adult Day Health Services at Clinton2 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.

• Senior Care Centers of Mississippi,LLC

  • Respite Care
  • Clinton, MS
  • NPI 1992919906
  NPD tax ID

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275747289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 NESHAMINY INTERPLEX",
            "address_2": "SUITE 403",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "19053",
            "telephone_number": "215-642-6600",
            "fax_number": "215-642-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 OLD CANTON RD",
            "address_2": "SUITE 140",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112946",
            "telephone_number": "601-956-7794",
            "fax_number": "601-206-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE CENTERS OF MISSISSIPPI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEHNERT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770373",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Adult Day Health Services of N. Jackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Self, FNP
• Gary Dwayne Self
• Morgan Elizabeth Self
• Lyser N Selmon
• Nancy Selph
• Senior Resources Healthcare Services,LLC
• Senior Services, LLC
• Cynthia Lynne Senior, RDH
• Michal Senitko, M.D.
• Bruce Stocker Senter, MD

• Respite Care in Jackson, MS
• Providers in Jackson, MS by specialty
• Respite Care 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.