NPIMap

Organization Active NPI

Falcon Crest Personal Care Assisted Living

  • Assisted Living Facility (Mental Illness)
  • Hattiesburg, MS
National Provider Identifier
1831556331
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
1092 Issued in MS
Legal business name
FALCON CREST PERSONAL CARE ASSISTED LIVING
Practice address
4 Falcon LN
Hattiesburg, MS 39401-9350
Phone
(601) 336-4590
Fax
(601) 336-4598
NPI assigned
Jan 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
Susan M Parker, RN
Title
Administrator
Phone
(601) 336-4590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X 1092 MS Primary

Addresses

Primary practice location

4 Falcon LN
Hattiesburg, MS 39401-9350

Mailing address

4 Falcon LN
Hattiesburg, MS 39401-9350
Phone (601) 336-4590

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1831556331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FALCON LN",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394019350",
            "telephone_number": "601-336-4590",
            "fax_number": "601-336-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FALCON LN",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394019350",
            "telephone_number": "601-336-4590",
            "fax_number": "601-336-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALCON CREST PERSONAL CARE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-336-4590",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MS",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.