Community Adult Day Care

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

COMMUNITY ADULT DAY CARE

Practice address

114 S Edwards Avenue
Mound Bayou, MS 38762

Phone

(662) 719-2005

NPI assigned

Mar 20, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Beverly C Johnson, MSW

Title

Administrator

Phone

(662) 719-2005

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1629310487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 HOLT ST",
            "address_2": "BOX 3",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387629759",
            "telephone_number": "662-719-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S EDWARDS AVENUE",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "38762",
            "telephone_number": "662-719-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ADULT DAY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-719-2005",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lasheena Armstrong, MSN CNM RNC-OB
• George Benford, D.M.D.
• Waynesha E Blaylock, MD
• Marketta Blue
• Nutusha Burns
• Delta Health Center
• Delta Health Center
• Delta Health Center
• Delta Health Center
• Delta Health Center

• Adult Day Care Clinic/Center in Mound Bayou, MS
• Providers in Mound Bayou, MS by specialty
• Adult Day Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; 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.