Riverbirch Residence LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

839 Issued in MS

Legal business name

RIVERBIRCH RESIDENCE LLC

Practice address

2554 Main St
Plantersville, MS 38862-7908

Phone

(662) 844-3451

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert J Lemmons

Title

Administrator

Phone

(662) 844-3451

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1326183237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "PLANTERSVILLE",
            "state": "MS",
            "postal_code": "388620159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 MAIN ST",
            "city": "PLANTERSVILLE",
            "state": "MS",
            "postal_code": "388627908",
            "telephone_number": "662-844-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERBIRCH RESIDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "LEMMONS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-844-3451",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MS",
            "license": "839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.