Greenville Assisted Living

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

GREENVILLE ASSISTED LIVING

Practice address

1880 Fairground Road
Greenville, MS 38703

Phone

(662) 334-4646

Fax

(662) 334-4691

NPI assigned

Feb 6, 2024

Organization subpart

No

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

Authorized official

Name

James Murry Reagor

Title

Sole Owner

Phone

(662) 334-4646

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1851155394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 FAIRGROUND ROAD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38703",
            "telephone_number": "662-334-4646",
            "fax_number": "662-334-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 FAIRGROUND ROAD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38703",
            "telephone_number": "662-334-4646",
            "fax_number": "662-334-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "REAGOR",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MURRY",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "662-334-4646"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Williams Grant, MSW,PCMHT
• Green Leaf Home Care, L.L.C
• Lemarrick Green, MHT
• Nellie Green
• Greenville Ambulatory Surgery Center, LLC (Greenville Ambulatory Surgery Center)
• Greenville Chiropractic Clinic, Inc
• Greenville Dental Clinic
• Greenville Eye Clinic P.a.
• Greenville Family Clinic Inc (Greenville Family Clinic)
• Greenville Family Medical Center Inc (Family Medical Center)

• Custodial Care Facility in Greenville, MS
• Providers in Greenville, MS by specialty
• Custodial Care Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.