Professional Staffing Solutions Adult Day Services, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

R863014 Issued in MS

Legal business name

PROFESSIONAL STAFFING SOLUTIONS ADULT DAY SERVICES, LLC

Doing business as

Professional Staffing Solutions

Practice address

1633 Broadway Ext N # P
Greenville, MS 38703-1942

Phone

(662) 335-5554

Fax

(662) 335-5580

NPI assigned

Dec 9, 2017

Last updated

May 9, 2019By 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

Mrs. Pandora Redmond, RN

Title

Owner/Administrator

Phone

(662) 822-1924

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 2

• PROFESSIONAL STAFFING SOLUTIONS Doing business as
• PROFESSIONAL STAFFING SOLUTIONS & ADULT DAY SERVICES, INC. Former legal business name

Locations

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.

• Pandora Redmond-Wills, RN

  • Adult Day Care Clinic/Center
  • Greenville, MS
  • NPI 1760049829
  NPD (past)

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

{
    "created_epoch": "1512777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1316452501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4580",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387044580",
            "telephone_number": "662-335-5554",
            "fax_number": "662-335-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 BROADWAY EXT N # P",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387031942",
            "telephone_number": "662-335-5554",
            "fax_number": "662-335-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "749 Main St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "MS",
            "postal_code": "387014108",
            "country_code": "US",
            "telephone_number": "662-335-5554",
            "fax_number": "662-335-5580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL STAFFING SOLUTIONS ADULT DAY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-09",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "REDMOND",
        "authorized_official_first_name": "PANDORA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "662-822-1924",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MS",
            "license": "R863014",
            "primary": true
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "MS",
            "license": "R863014",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "MS",
            "license": "R863014",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08679792",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07331397",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06908787",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL STAFFING SOLUTIONS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROFESSIONAL STAFFING SOLUTIONS & ADULT DAY SERVICES, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Adult Day Care Clinic/Center in Greenville, MS
• Providers in Greenville, MS by specialty
• Adult Day Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.