NPIMap

Organization Active NPI

Hope Supportive LLC.

  • In Home Supportive Care Agency
  • Jackson, MS
National Provider Identifier
1639776750
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HOPE SUPPORTIVE LLC.
Practice address
6295 Old Canton Rd Apt 19D
Jackson, MS 39211-2934
Phone
(414) 916-6771
NPI assigned
Oct 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Elan TillmanNPI 1659738938
Title
Owner
Phone
(414) 916-6771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

6295 Old Canton Rd Apt 19D
Jackson, MS 39211-2934

Mailing address

6295 Old Canton Rd Apt 19D
Jackson, MS 39211-2934
Phone (414) 916-6771

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1639776750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6295 OLD CANTON RD APT 19D",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112934",
            "telephone_number": "414-916-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6295 OLD CANTON RD APT 19D",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112934",
            "telephone_number": "414-916-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE SUPPORTIVE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "ELAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-916-6771"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.