Pavilion Personal Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PAVILION PERSONAL CARE LLC

Practice address

1450B Beach Blvd
Biloxi, MS 39530

Phone

(612) 940-5934

NPI assigned

Jun 6, 2013

Organization subpart

No

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

Authorized official

Name

Mark David Kluempke

Title

Chief Manager

Phone

(612) 940-5934

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1326486804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8056",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395358056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450B BEACH BLVD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39530",
            "telephone_number": "612-940-5934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION PERSONAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "KLUEMPKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "612-940-5934"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "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 Jun 6, 2013; 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.