Grenada Rehabilitation and Healthcare Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

503 Issued in MS

Legal business name

GRENADA REHABILITATION AND HEALTHCARE CENTER, LLC

Practice address

1966 Hill Dr
Grenada, MS 38901-5047

Phone

(662) 226-2442

Fax

(662) 226-9567

NPI assigned

May 11, 2006

Organization subpart

Yes

Parent organization

ARK MISSISSIPPI HOLDING COMPANY, LLCAs reported in NPPES

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

Authorized official

Name

Michelle D Meer

Title

Vice President & Secretary

Phone

(629) 626-0000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1720038425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1966 HILL DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389015047",
            "telephone_number": "662-226-2442",
            "fax_number": "662-226-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1966 HILL DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389015047",
            "telephone_number": "662-226-2442",
            "fax_number": "662-226-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRENADA REHABILITATION AND HEALTHCARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARK MISSISSIPPI HOLDING COMPANY, LLC",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "MEER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "629-626-0000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230070",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grenada Lake Medical Center (Grenada Specialty Clinic (GSC))
• Grenada Lake Medical Center DME
• Grenada Pharmnet
• Grenada Physical Therapy, Inc
• Grenada Physician Services, LLC
• Grenada School District
• Grenada School District
• Grenada School District
• Grenada School District
• Cesar Enrique Guerrero, MD

• Skilled Nursing Facility in Grenada, MS
• Providers in Grenada, MS by specialty
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.