Desoto Community Care Center LLC
Organization Active NPI Skilled Nursing Facility · Horn Lake, MS
NPI 1831147677 · NPPES record last updated Apr 30, 2013
Key facts
- NPI
- 1831147677
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 943 (MS)
- Legal business name
- DESOTO COMMUNITY CARE CENTER LLC
- Practice address
- 3068 Nail Rd W
Horn Lake, MS 38637-3002 - Phone
- (662) 280-1219
- Fax
- (662) 280-4668
- NPI assigned
- May 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Toni Parkinson
- Title
- Authorized Representative
- Phone
- (601) 709-1408
Owners & managing parties with NPI records 1
-
Sunil Malhotra, MD
Facilities with the same owner 54
Practitioners 1
-
Sunil Malhotra, MD
Affiliated clinicians 1
-
Sunil Malhotra, MD
Medicare Care Compare: Nursing home
- Listed as
- Landmark of Desoto
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Oct 11, 2001
- Medicare certification status
- Active
- Certified beds
- 60 · 53.6 residents per day on average
- Chain
- The Beebe Family
- Penalties (3 years)
- 2 · fines totaling $10,527
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0986875 | Landmark of Desoto | Certificate of waiver | May 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Skilled nursing facility certification: CCN 255281
- Legal name
- DESOTO COMMUNITY CARE CENTER LLC
- Doing business as
- LANDMARK OF DESOTO
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 11, 2001
- Last certification
- Oct 30, 2024
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 3068 Nail Rd W
Horn Lake, MS 38637-3002 - Nursing home name
- LANDMARK OF DESOTO
- Affiliated entity
- THE BEEBE FAMILY
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Elton G. Beebe Sr Irrv Childrens TR |
5% Or Greater Indirect Ownership Interest | Oct 1, 2023 | 85% |
| Adp of the SNF | Jan 1, 2025 | ||
| Elton G Beebe Sr Irrv Grndchildrens TR |
5% Or Greater Direct Ownership Interest | Jan 1, 2010 | 15% |
| Felicia Stallard |
5% Or Greater Direct Ownership Interest | Jan 1, 2010 | |
| Corporate Director |
Jan 1, 2005 | ||
| Sunil Malhotra |
Operational/Managerial Control | Jul 22, 2017 | |
| Adp of the SNF | Jul 22, 2017 | ||
| Ruby White |
Operational/Managerial Control | Jan 4, 2022 | |
| Account Management Services Inc |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Regional Care LLC |
Operational/Managerial Control | Jan 1, 2014 | |
| Elton G Beebe |
5% Or Greater Direct Ownership Interest | Jan 1, 2010 | |
| Corporate Director |
Jan 1, 1993 | ||
| Linda Maynor |
Adp of the SNF | Jan 1, 2011 | |
| Regional Services, Inc |
Operational/Managerial Control | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Toni H Parkinson |
Corporate Officer |
Nov 15, 2015 | |
| Operational/Managerial Control | Jan 1, 2010 | ||
| Adp of the SNF | Jan 1, 2010 | ||
| Provider Professional Services Inc |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Mississippi Extended Care Centers |
Adp of the SNF | Jan 1, 2025 | |
| Nutrition Systems Consulting Inc |
Adp of the SNF | Jan 31, 2008 | |
| Alison Sadler |
5% Or Greater Direct Ownership Interest | Jan 1, 2010 | |
| Corporate Director |
Jan 1, 2005 | ||
| Administrative Systems Inc |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| David W Stallard |
Corporate Officer |
Sep 14, 2004 | |
| Corporate Director |
Jan 1, 1997 | ||
| Operational/Managerial Control | Jan 1, 2010 | ||
| Adp of the SNF | Jan 1, 2010 | ||
| Bobby L Beebe |
5% Or Greater Direct Ownership Interest | Jan 1, 2010 | 100% |
| Operational/Managerial Control | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Providence Care LLC |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Rachel Keen |
Corporate Officer |
Jan 1, 2013 | |
| Roberta Loggins |
Operational/Managerial Control | Feb 28, 2022 | |
| Adp of the SNF | Feb 28, 2022 | ||
| Tristar Rehab Inc |
Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| Pathway Management Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2014 | 75% |
| Health Care Services, Inc. |
5% Or Greater Direct Ownership Interest | Jan 1, 2010 | 85% |
| Operational/Managerial Control | Jan 1, 2010 | ||
| Adp of the SNF | Jan 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080114000360 | MS | Part a Provider - Skilled Nursing Facility | 3072694256 | Practice locations: Horn Lake, MS |
National Provider Directory
Locations
3068 Nail Rd W
Horn Lake, MS 38637
Phone (662) 280-1219
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 943 | MS | Yes |
Addresses
Primary practice location
3068 Nail Rd W
Horn Lake, MS 38637-3002
Mailing address
3068 Nail Rd W
Horn Lake, MS 38637-3002
Phone (662) 280-1219
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00230171 | Medicaid | MS | |
| 000080379 | Other | MS | BLUE CROSS BLUE SHIELD MS |
Other names
- Landmark of Desoto
Other providers in Horn Lake, MS
- Sarah Frances Crain
- Angie Crow
- Shelly Curtis
- Christine Davidson
- Dental Professionals of Mississippi, P.C.
- Gregory Kyle Dixon
- Tyshianna B Edwards
- Lanique Ervin
- Essential Health & Wellness Clinic P.a.
- Jenna Evers
All providers in Horn Lake, MS · Skilled Nursing Facility in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.