Personal Care Home of Wiggins
Organization Active NPI Assisted Living Facility (Mental Illness) · Wiggins, MS
NPI 1386950145 · NPPES record last updated Aug 30, 2010
Key facts
- NPI
- 1386950145
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility (Mental Illness) 3104A0625X
- License
- 1038 (MS)
- Legal business name
- PERSONAL CARE HOME OF WIGGINS
- Practice address
- 918 Parkway Dr
Wiggins, MS 39577-8750 - Phone
- (601) 928-4663
- Fax
- (601) 928-4668
- NPI assigned
- Aug 30, 2010
- Organization subpart
- No
Authorized official
- Name
- Angela C Harris
- Title
- Owner/Administrator
- Phone
- (601) 325-4577
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 1038 | MS | |
| Assisted Living Facility (Mental Illness) | 3104A0625X | 1038 | MS | Yes |
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | 1038 | MS |
Addresses
Primary practice location
918 Parkway Dr
Wiggins, MS 39577-8750
Mailing address
918 Parkway Dr
Wiggins, MS 39577-8750
Phone (601) 928-4663
Other providers in Wiggins, MS
- Dillon Ott
- Erica R Palmer
- Leslie Parker
- Rebekah Parker
- Robert K Partrige
- Hannah Jean Peterman
- Vera Phenice
- Jeffrey N Potter
- Quest Rehab, Inc.
- Aesha Rahman
All providers in Wiggins, MS · Assisted Living Facility (Mental Illness) in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.