Viola Williams – Adult Day Care Clinic/Center

Key facts

NPI: 1972174480
Entity type: Individual (NPI type 1)
Primary specialty: Adult Day Care Clinic/Center 261QA0600X
Practice address: 812 Highway 82 E
Leland, MS 38756-9647
Phone: (662) 704-5037
NPI assigned: Jul 6, 2021
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Angel Keeper Adult Day Care Adult Day Care Clinic/Center · Leland, MS · NPI 1134794365

NPD ADULT DAY CARE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Angel Keeper Adult Day Care	Adult Day Care	Current since Jul 17, 2021	Accepting new patients

Locations

812 Highway 82 E
Leland, MS 38756
Phone (662) 704-5037

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Day Care Clinic/Center	261QA0600X			Yes

Addresses

Primary practice location

812 Highway 82 E
Leland, MS 38756-9647

Mailing address

812 Highway 82 E
Leland, MS 38756-9647
Phone (662) 704-5037

Other identifiers

Identifier	Type	State	Issuer
04403511	Medicaid	MS

Electronic endpoints

Type	Endpoint	Use	Affiliation
CONNECT URL	Leland	Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 6, 2021.

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1972174480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 HIGHWAY 82 E",
            "city": "LELAND",
            "state": "MS",
            "postal_code": "387569647",
            "telephone_number": "662-704-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 HIGHWAY 82 E",
            "city": "LELAND",
            "state": "MS",
            "postal_code": "387569647",
            "telephone_number": "662-704-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VIOLA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04403511",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Leland",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "812 Highway 82 E",
            "city": "Leland",
            "state": "MS",
            "country_code": "US",
            "postal_code": "387569647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leland, MS

All providers in Leland, MS · Adult Day Care Clinic/Center in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.