Shanell'S Residential Care Home, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1035 Issued in MS

Legal business name

SHANELL'S RESIDENTIAL CARE HOME, INC.

Doing business as

Shanell's Residential Care Home, Inc. (Assistant Living)

Practice address

4022 California Ave
Jackson, MS 39213-5513

Phone

(601) 362-4549

NPI assigned

Apr 29, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Carnell Kitchens

Title

President

Phone

(601) 259-4602

Specialties & licenses 1

Addresses

Other names 1

• Shanell's Residential Care Home, Inc. (Assistant Living) Doing business as

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1528359189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 83040",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392833040",
            "telephone_number": "601-362-4549",
            "fax_number": "601-713-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 CALIFORNIA AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392135513",
            "telephone_number": "601-362-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANELL'S RESIDENTIAL CARE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-29",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "KITCHENS",
        "authorized_official_first_name": "CARNELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-259-4602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MS",
            "license": "1035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shanell's Residential Care Home, Inc. (Assistant Living)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jay G Shake, MD
• Nazneen Shakeel
• Divya Shakti, MD
• Ipsa Shakya, MBBS
• Susan Elizabeth Shamburger, M.D.
• Jason J Shannon, CRNA
• Towanda Cook Sharkey, NP
• Rajesh Kumar Sharma, M.D., PH.D., M.B.A.
• Christie Sharp
• Lores Sharp

• Assisted Living Facility in Jackson, MS
• Providers in Jackson, MS by specialty
• Assisted Living Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.