Exceptional Living Home Health Care Agency,LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

EXCEPTIONAL LIVING HOME HEALTH CARE AGENCY,LLC

Practice address

6385 Chesterville Rd
Tupelo, MS 38801-8012

Phone

(662) 947-3004

NPI assigned

Jan 25, 2021

Last updated

Jan 25, 2021By 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

Dominique Bailey

Title

Chief Executive Officer

Phone

(662) 947-3004

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1528658390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 TRACE COLONY PARK DR STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391578810",
            "telephone_number": "662-947-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 CHESTERVILLE RD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388018012",
            "telephone_number": "662-947-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEPTIONAL LIVING HOME HEALTH CARE AGENCY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "662-947-3004"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Fred Everitt III, DDS
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• Sawyer Ewing
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• Jennifer Ezell

• Home Health Aide in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Home Health Aide in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.