Ancor Adult Day Care Center

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

00437897 Issued in MS

Legal business name

ANCOR ADULT DAY CARE CENTER

Practice address

813 Hancock Street
Tutwiler, MS 38963

Phone

(662) 345-0222

NPI assigned

Nov 23, 2007

Last updated

May 13, 2008By 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

Mr. Bertrand Antoine

Title

President

Phone

(662) 345-0222

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Ancor Adult Day Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Ancor Corporation

  • Community/Behavioral Health Agency
  • Clarksdale, MS
  • NPI 1912238437
  NPD tax ID

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1699956268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1007",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351007",
            "telephone_number": "662-345-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 HANCOCK STREET",
            "city": "TUTWILER",
            "state": "MS",
            "postal_code": "38963",
            "telephone_number": "662-345-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCOR ADULT DAY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "ANTOINE",
        "authorized_official_first_name": "BERTRAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-345-0222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MS",
            "license": "00437897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08081816",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00437897",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Essie Hooper Adams, M.ED.
• Angelize LLC (Angelize Care)
• Eileen Breen, APRN BC
• Anne E Brooks, DO
• Destiny Hospice Palliative Care Specialty Sercices Inc
• Pattye Dorris, AGNP

• Exclusive Provider Organization in Tutwiler, MS
• Providers in Tutwiler, MS by specialty
• Exclusive Provider Organization in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.