Emeritol Lo Hattiesburg, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EMERITOL LO HATTIESBURG, LLC

Doing business as

Brookdale Hattiesburg I

Practice address

103 Fox Chase Dr
Hattiesburg, MS 39402-2575

Phone

(601) 271-2177

NPI assigned

Mar 14, 2025

Organization subpart

No

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

Authorized official

Name

Anna F.C. Munoz

Title

Assistant Secretary

Phone

(414) 918-5443

Specialties & licenses 1

Addresses

Other names 1

• Brookdale Hattiesburg I Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1891595393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FOX CHASE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022575",
            "telephone_number": "601-271-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FOX CHASE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022575",
            "telephone_number": "601-271-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITOL LO HATTIESBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "F.C.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Hattiesburg I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Assisted Living Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.