NPIMap

Organization Active NPI

Emmanuel Recreational Center

  • Adult Day Care Clinic/Center
  • Pace, MS
National Provider Identifier
1548644644
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
1071260 Issued in MS
Legal business name
EMMANUEL RECREATIONAL CENTER
Practice address
101 Bizzell St
Pace, MS 38764-0162
Phone
(662) 723-0034
Fax
(662) 723-0034
NPI assigned
Jul 17, 2015
Last updated
Jul 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Ms. Brenda Jean Bryant
Title
Owner
Phone
(662) 723-0034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 1071260 MS Primary

Addresses

Primary practice location

101 Bizzell St
Pace, MS 38764-0162

Mailing address

PO Box 162
101 Bizzell St
Pace, MS 38764-0162
Phone (662) 723-0034

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1548644644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 162",
            "address_2": "101 BIZZELL ST",
            "city": "PACE",
            "state": "MS",
            "postal_code": "387640162",
            "telephone_number": "662-723-0034",
            "fax_number": "662-723-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BIZZELL ST",
            "city": "PACE",
            "state": "MS",
            "postal_code": "387640162",
            "telephone_number": "662-723-0034",
            "fax_number": "662-723-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL RECREATIONAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-723-0034",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MS",
            "license": "1071260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.