Light of the World Adult Day Care, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

111111111 Issued in MS

Legal business name

LIGHT OF THE WORLD ADULT DAY CARE, LLC

Practice address

405 W Gresham St
Indianola, MS 38751-2053

Phone

(662) 207-3744

NPI assigned

Apr 11, 2014

Last updated

Apr 11, 2014By 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

Mrs. Terry Hutchins

Title

Owner

Phone

(662) 207-3744

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1659790152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W GRESHAM ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512053",
            "telephone_number": "662-207-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRESHAM ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512053",
            "telephone_number": "662-207-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT OF THE WORLD ADULT DAY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-11",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "HUTCHINS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-207-3744",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MS",
            "license": "111111111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1111111111",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indianola, MS
• Providers in Indianola, MS by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.