Madison Haywood County Developmental Services, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

6292 Issued in TN

Legal business name

MADISON HAYWOOD COUNTY DEVELOPMENTAL SERVICES, INC

Practice address

38 Garland Dr
Jackson, TN 38305-3602

Phone

(731) 664-0855

Fax

(731) 668-2433

NPI assigned

Feb 23, 2007

Last updated

Feb 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tomika Barbour

Title

Qa Manager

Phone

(731) 664-0855

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 2

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1902931314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11205",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383080120",
            "telephone_number": "731-664-0855",
            "fax_number": "731-668-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 GARLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053602",
            "telephone_number": "731-664-0855",
            "fax_number": "731-668-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON HAYWOOD COUNTY DEVELOPMENTAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "BARBOUR",
        "authorized_official_first_name": "TOMIKA",
        "authorized_official_title_or_position": "QA MANAGER",
        "authorized_official_telephone_number": "731-664-0855"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TN",
            "license": "6292",
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TN",
            "license": "6295",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TN",
            "license": "6297",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TN",
            "license": "6293",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TN",
            "license": "6294",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMRS PROVIDER NUMBER",
            "identifier": "00068",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhds@mhds.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "38 Garland Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383053602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhds@mhds.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "38 Garland Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383053602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Jackson, TN
• Providers in Jackson, TN by specialty
• Developmentally Disabled Services Day Training Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.