CLEVELAND PCH RESIDENTIAL LIVING, LLC (NPI# 1023169158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023169158 |
| Entity Type | Organization |
| Organization Name | CLEVELAND PCH RESIDENTIAL LIVING, LLC |
| Other Organization Name | CLEVELAND PERSONAL CARE COMMUNITY |
| Practice Address |
800 Third Street Cleveland MS 38732 |
| Practice Telephone | 6628466160 |
| Practice Fax Number | 6628466164 |
| Mailing Telephone | 6628466160 |
| Mailing Fax Number | 6628466164 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-12-26 |
| Authorized Official Name | MRS. MEGAN P YOUNG (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6628466160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 978 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08073094 | 05 |
| Other Name | Type Code |
|---|---|
| Cleveland Personal Care Community | Doing Business As Name - Organization |
| Street Address |
800 THIRD STREET |
| City | CLEVELAND |
| State | MS |
| Zip Code | 38732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023629219 | Marilynn Pruitt | Technician | 108 Belvedere Court, Cleveland, MS 38732 | 2020-08-12 |
| 1417322587 | United Family Life Center | Clinic/Center | 1101 S Martin Luther King Drive, Cleveland, MS 38732 | 2015-12-01 |
| 1346661584 | Rebecca Winters | Speech-Language Pathologist | 4036 Hwy 8 East, Cleveland, MS 38732 | 2013-12-13 |
| 1982973186 | Delta Home Health Inc | Home Health | 300-b South Street, Cleveland, MS 38732 | 2011-12-19 |
| 1730467382 | Reid Farmer Davis Medico | Clinic/Center | 4080 Highway 8 West, Cleveland, MS 38732 | 2011-08-01 |
| 1700181427 | Sondra Speakes Huerta | Speech-Language Pathologist | 3939 Hwy 61 N. Suite 110, Cleveland, MS 38732 | 2011-01-12 |
| 1386956027 | Delta Soul Medical, LLC | Hospice Care, Community Based | 102 N. Pearman Ave., Ste. 1, Cleveland, MS 38732 | 2010-07-10 |
| 1700029675 | Jlrl, LLC | Dentist | 716 First Street, Cleveland, MS 38732 | 2009-04-08 |
| 1417194978 | Bolivar Emergency Group LLC | Physician Assistant | 901 Hwy 8 East Sunflower Rd, Cleveland, MS 38732 | 2009-01-20 |
| 1902055767 | Word of Deliverance Adult Day Care | Custodial Care Facility | 509 Davis Avenue, Cleveland, MS 38732 | 2008-09-16 |
| Find all providers in zip 38732 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114578234 | Homewood Senior Living, LLC | Assisted Living Facility | 3 Homewood Way, Cleveland, OH 44143-2955 | 2019-09-20 |
| 1629531058 | Larchwood Care LLC | Assisted Living Facility | 4106 Rocky River Dr, Cleveland, OH 44135-1174 | 2019-04-11 |
| 1942559745 | Indywood Estate, LLC | Assisted Living Facility | 218 Ronaldman Rd, Cleveland, MS 38732-8755 | 2012-09-07 |
| 1063652139 | St. Augustine Manor Corp. | Assisted Living Facility | 7821 Lake Avenue, St. Augustine Towers, Cleveland, OH 44102 | 2009-03-02 |
| 1609026483 | American Retirement Corporation | Assisted Living Facility | 3151 Mayfield Rd, Cleveland, OH 44118-1757 | 2008-09-29 |
| 1164460556 | Morningside of Cleveland, LLC | Assisted Living Facility | 2900 Westside Dr Nw, Cleveland, TN 37312-3506 | 2006-06-04 |
| 1124066865 | United Home Care Inc | Assisted Living Facility | 471 S Main St, Suite B, Cleveland, GA 30528-1409 | 2006-06-03 |
| 1982252789 | Snh Tenn Tenant LLC | Assisted Living Facility | 2900 Westside Dr Nw, Cleveland, TN 37312-3506 | 2019-08-27 |
| 1720410178 | Larchwood Health Group LLC | Assisted Living Facility | 4110 Rocky River Dr, Cleveland, OH 44135-1175 | 2013-08-07 |
| 1750626594 | Genesis Rehab Services | Assisted Living Facility | 1890 E 107th St, Cleveland, OH 44106-2235 | 2012-12-05 |
| Find all providers in CLEVELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.