THE COVINGTON'S COVE ASSISTED LIVING CENTER LLC (NPI# 1043671704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043671704 |
| Entity Type | Organization |
| Organization Name | THE COVINGTON'S COVE ASSISTED LIVING CENTER LLC |
| Practice Address |
192 Mary Magdalene Church Rd Hattiesburg MS 39401 |
| Mailing Address |
510 Maple Dr Petal MS 39465-6816 |
| Practice Telephone | 6013108014 |
| Mailing Telephone | 6013108014 |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2016-03-09 |
| Authorized Official Name | MR. TRAVIS MONTEZ DELOACH (OWNER) |
| Authorized Official Telephone | 6013108014 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
192 MARY MAGDALENE CHURCH RD |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| 1427496926 | Vickie Ann Bogan | Developmental Therapist | 20 Parkway Bldv., Hattisburg, MS 39401 | 2013-06-06 |
| Find all providers in zip 39401 | ||||
| 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 |
|---|---|---|---|---|
| 1730415035 | Emeritus Corporation | Assisted Living Facility | 103 Fox Chase Dr, Hattiesburg, MS 39402-2575 | 2009-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215558747 | Waymaker Enterprises, LLC | Assisted Living Facility | 204 Bradfield Rd, Madison, MS 39110-7035 | 2020-05-06 |
| 1417508110 | Maxine Delores Harris | Assisted Living Facility | 104 Martin Luther King Blvd, Arcola, MS 38722 | 2019-09-24 |
| 1548819733 | Snh Omiss Tenant LLC | Assisted Living Facility | 1488 Belk Blvd, Oxford, MS 38655-5356 | 2019-09-10 |
| 1457900649 | Snh Omiss Tenant LLC | Assisted Living Facility | 108 Clarington Dr, Southaven, MS 38671-5640 | 2019-09-10 |
| 1972152619 | The Claiborne At Adelaide | Assisted Living Facility | 74 Claiborne Way, Starkville, MS 39759-8544 | 2019-09-05 |
| 1992369102 | James Wilson | Assisted Living Facility | 15986 W Main St, Louisville, MS 39339-2636 | 2019-04-24 |
| 1023519766 | The Blake At Oxford | Assisted Living Facility | 110 Ed Perry Blvd, Oxford, MS 38655-3452 | 2018-02-27 |
| 1194224873 | Barnes Crossing Retirement Community LLC | Assisted Living Facility | 1090 County Road 811, Saltillo, MS 38866-7304 | 2018-02-07 |
| 1649782202 | Garden Hill Assisted Living | Assisted Living Facility | 2082 Yorkville Rd E, Columbus, MS 39702-9406 | 2017-11-03 |
| 1891228581 | Magnolia Gardens Assisted Living | Assisted Living Facility | 303 East Ivy, Ellisville, MS 39437 | 2017-04-10 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
Please comment or provide details below to improve the information on THE COVINGTON'S COVE ASSISTED LIVING CENTER LLC.
| 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.