Senior Care Centers of Mississippi,LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

SENIOR CARE CENTERS OF MISSISSIPPI,LLC

Practice address

503 E Northside Dr
Clinton, MS 39056-3618

Phone

(601) 926-1222

Fax

(601) 924-3907

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Craig O Mehnert

Title

Cfo

Phone

(215) 642-6600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baptist Adult Day Health Services at Clinton Doing business as

Tax ID family

Baptist Adult Day Health Services at Clinton2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Senior Care Centers of Mississippi, LLC

  • Respite Care
  • Jackson, MS
  • NPI 1275747289
  NPD tax ID

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992919906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 NESHAMINY INTERPLEX",
            "address_2": "SUITE 403",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "19053",
            "telephone_number": "215-642-6600",
            "fax_number": "215-642-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E NORTHSIDE DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563618",
            "telephone_number": "601-926-1222",
            "fax_number": "601-924-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE CENTERS OF MISSISSIPPI,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEHNERT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770375",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Adult Day Health Services at Clinton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deva Sandroni, PHARMD
• Destiny Scott, PHARMD
• Maria Annette Seale
• McRaney Elizabeth Seale
• Joyce Miranda Sellers, R.N.
• Serenityhomecare
• Dottie Elizabeth Serio, LMFT
• Hallie Marie Sessums
• Ivey Burt Shelton, FNP
• Kristian Shields

• Respite Care in Clinton, MS
• Providers in Clinton, MS by specialty
• Respite Care in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.