EMMANUEL RIDGE HOUSING INC (NPI# 1033508809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033508809 |
| Entity Type | Organization |
| Organization Name | EMMANUEL RIDGE HOUSING INC |
| Other Organization Name | ASSISTED/EXTENDED STAY FACILITY |
| Practice Address |
803 W Main St Louisville MS 39339-2539 |
| Mailing Address |
750 Boling St Suite H Jackson MS 39209-2652 |
| Practice Telephone | 6627055031 |
| Practice Fax Number | 6627055034 |
| Mailing Telephone | 7692337439 |
| Mailing Fax Number | 7692510257 |
| Enumeration Date | 2015-01-17 |
| Last Update Date | 2015-01-17 |
| Authorized Official Name | MRS. BEATRICE A EZEM (CEO) |
| Authorized Official Telephone | 6019279839 |
| Authorized Official Credential | RN,CM,CLNC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
MS | Nursing & Custodial Care Facilities | |
| Y | 310400000X | Assisted Living Facility | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08762218 | 05 | |
| MS | 03630719 | 05 | |
| MS | 07123515 | 05 |
| Other Name | Type Code |
|---|---|
| ASSISTED/EXTENDED STAY FACILITY | Doing Business As Name - Organization |
| Street Address |
803 W MAIN ST |
| City | LOUISVILLE |
| State | MS |
| Zip Code | 39339-2539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962669614 | Jrs&j Adult Care Center, Inc | Assisted Living Facility | 803 W Main St, Louisville, MS 39339-2539 | 2008-05-20 |
| 1497144265 | Emmanuel Ridge of Louisville Ms Inc | Registered Nurse | 803 W Main St, Louisville, MS 39339-2539 | 2015-01-16 |
| 1265741300 | Jrs&j Adult Care Center, Inc. | Custodial Care Facility | 803 W Main St, Louisville, MS 39339-2539 | 2010-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972149573 | Thomas Cefalu | Pharmacist | 16575 E Main St, Louisville, MS 39339 | 2019-11-19 |
| 1720506371 | Jennifer Marie Burns | Physical Therapist | 110 N Walmart Drive Suite F, Louisville, MS 39339 | 2017-09-05 |
| 1326409335 | Courtney Nicole Shaw | Speech-Language Pathologist | 316 Rocky Hill Road, Louisville, MS 39339 | 2016-03-18 |
| 1033598503 | Winston Medical Clinic LLC | Clinic/Center | 16569 W Main St, Louisville, MS 39339 | 2015-05-29 |
| 1689969735 | Adam C Byrd | Dermatology | 313 N Court Ave, Ummc Dermatology - Louisville Clinic, Louisville, MS 39339 | 2011-06-16 |
| 1356587208 | Louisville Healthcare LLC | Skilled Nursing Facility | 543 East Main Street, Louisville, MS 39339 | 2008-12-24 |
| 1699935908 | Stephen Eugene Hunter | Emergency Medicine | 100 Ellie Smith Rd, Louisville, MS 39339 | 2008-06-10 |
| 1669566279 | Southern Pharmaceutical Corporation | Durable Medical Equipment & Medical Supplies | 17220 E Main St Ste C, Louisville, MS 39339 | 2006-10-03 |
| 1184737017 | Louisville Eye Care | Optometrist | 500 North Church, Louisville, MS 39339 | 2006-08-16 |
| 1679583249 | Raymond John Orgler | Surgery | 547 E. Main St, Louisville, MS 39339 | 2006-08-08 |
| Find all providers in zip 39339 | ||||
| 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 |
|---|---|---|---|---|
| 1396302113 | English Station Opco, LLC | Assisted Living Facility | 13700 English Villa Dr, Louisville, KY 40245-3938 | 2019-05-28 |
| 1992369102 | James Wilson | Assisted Living Facility | 15986 W Main St, Louisville, MS 39339-2636 | 2019-04-24 |
| 1366879959 | Oaklawn Development Operations, LLC | Assisted Living Facility | 100 Shelby Station Dr, Louisville, KY 40245-4734 | 2013-09-27 |
| 1740522481 | One Family Inc | Assisted Living Facility | 2206 Heather Ln Apt 414, Louisville, KY 40218-1074 | 2013-03-20 |
| 1891087441 | Donna C. Robinson, Aprn, Pllc | Assisted Living Facility | 2646 Kings Hwy, Louisville, KY 40205-2649 | 2011-05-13 |
| 1043513500 | Quality Care Inc | Assisted Living Facility | 3917 Miser Station Rd, Louisville, TN 37777-3513 | 2010-12-06 |
| 1255645115 | A2002 Senior, LLC | Assisted Living Facility | 3451 S Hurstbourne Pkwy, Louisville, KY 40299-7398 | 2010-08-03 |
| 1356678890 | Emeritus Corporation | Assisted Living Facility | 9251 Stonestreet Rd, Louisville, KY 40272-2858 | 2009-11-04 |
| 1649427063 | Arden Courts of Louisville Ky LLC | Assisted Living Facility | 10451 Linn Station Rd, Louisville, KY 40223-3835 | 2008-08-27 |
| 1962669614 | Jrs&j Adult Care Center, Inc | Assisted Living Facility | 803 W Main St, Louisville, MS 39339-2539 | 2008-05-20 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 39339 |
Please comment or provide details below to improve the information on EMMANUEL RIDGE HOUSING INC.
| 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.