NPIMap

Organization Active NPI

Magnolia Healthcare, Inc.

  • Skilled Nursing Facility
  • Greenville, MS
National Provider Identifier
1609964220
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
420 Issued in MS
Legal business name
MAGNOLIA HEALTHCARE, INC.
Practice address
402 Arnold Ave
Greenville, MS 38701-4713
Phone
(662) 332-0318
Fax
(662) 335-7892
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Authorized official

Name
Richard Thomas Daspit Sr.
Title
Ceo
Phone
(225) 906-4644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 420 MS Primary

Addresses

Primary practice location

402 Arnold Ave
Greenville, MS 38701-4713

Mailing address

PO Box 40018
Baton Rouge, LA 70835-0018
Phone (225) 753-0864

Other identifiers 1

IdentifierTypeStateIssuer
220309MedicaidMS

Other names 1

  • Arnold Avenue Nursing Home Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071023000313 MS Part A Provider - Skilled Nursing Facility 9638265531 Practice locations: Greenville, MS

Skilled nursing facility certification: CCN 255217

Legal name
MAGNOLIA HEALTHCARE, INC.
Doing business as
RIVER HEIGHTS HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1995
Last certification
Nov 21, 2023
Beds
60
Ownership / control type
Corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 14, 1995 in MS
Enrollment address
402 Arnold Ave
Greenville, MS 38701-4713
Nursing home name
RIVER HEIGHTS HEALTHCARE CENTER

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
River Heights Healthcare CenterCCN 255217 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6058.2 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $8,800

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0691520River Heights Healthcare Center402 Arnold Avenue, Greenville, MS 38701Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Arnold Avenue Nursing Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

402 Arnold Ave
Greenville, MS 38701
Phone (662) 332-0318

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Lynn Joyce Individual Corporate OfficerChief Financial Officer Aug 2, 2021
Cole T Hodges Individual Adp of the SNF Jun 16, 2025
Isley a Carter Individual Adp of the SNF Jun 16, 2025
Lonnie L Peeler Individual Corporate OfficerChief Operating Officer Jun 1, 2014
Operational/Managerial Control Jun 1, 2014
Adp of the SNF Jun 1, 2014
Richard T Daspit Individual Corporate OfficerPresident/Ceo Jan 17, 2014
Corporate DirectorPresident, Board Member Dec 1, 1995

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1609964220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40018",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708350018",
            "telephone_number": "225-753-0864",
            "fax_number": "225-753-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ARNOLD AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014713",
            "telephone_number": "662-332-0318",
            "fax_number": "662-335-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "DASPIT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-906-4644",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220309",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arnold Avenue Nursing Home",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Arnold Avenue Nursing Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.