EMMANUEL RIDGE COMMUNITY SERVICE ORGANIZATION (NPI# 1245415645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245415645 |
| Entity Type | Organization |
| Organization Name | EMMANUEL RIDGE COMMUNITY SERVICE ORGANIZATION |
| Other Organization Name | EMMANUEL RIDGE SENIOR DAY CARE CENTER |
| Practice Address |
2073 Hwy 49 South Florence MS 39073-1944 |
| Mailing Address |
2073 Highway 49 S Florence MS 39073-9422 |
| Practice Telephone | 6017093304 |
| Practice Fax Number | 6017093307 |
| Mailing Telephone | 6017093304 |
| Mailing Fax Number | 6017093307 |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-01-03 |
| Authorized Official Name | MS. BEATRICE A EZEM (PRESIDENT/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 |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08752218 | 05 |
| Other Name | Type Code |
|---|---|
| Emmanuel Ridge Senior Day Care Center | Doing Business As Name - Organization |
| Street Address |
2073 HWY 49 SOUTH |
| City | FLORENCE |
| State | MS |
| Zip Code | 39073-1944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235314634 | Emmanuel Ridge Home Care Agency Inc | Non-emergency Medical Transport (VAN) | 2073 Hwy 49 South, Florence, MS 39073-1944 | 2008-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497295117 | Eletha Walker | Massage Therapist | 215 Walker Smith Rd, Florence, MS 39073 | 2017-02-28 |
| 1154691004 | Freds Stores of Tennessee Inc | Pharmacy | 2932 Hwy 49 S., Florence, MS 39073 | 2012-01-10 |
| 1538330444 | Florence Dental Clinic | Dentist | 129 Earl Clark Drive, Florence, MS 39073 | 2008-03-19 |
| 1548323579 | Thomas Raymond Byrd | Dentist | 129 Earl Clark Dr., Florence, MS 39073 | 2006-12-19 |
| 1841384443 | Kelley N Martin | Nurse Practitioner | 218 East Main Street, Florence, MS 39073 | 2006-10-03 |
| 1851484422 | Derek Wade Puckett | Physical Therapist | 3000 Hwy 49 South, Florence, MS 39073 | 2006-10-02 |
| 1508961947 | Polks Discount Drugs #2 | Pharmacy | 101 49 Place, Florence, MS 39073 | 2006-09-13 |
| 1669652558 | Martin Health Care, LLC | Family Medicine | 218 East Main St, Florence, MS 39073-0530 | 2007-11-07 |
| 1316073307 | Norma M Raymond | Pharmacist | 106 Raymond Gdn, Florence, MS 39073-4402 | 2007-02-26 |
| 1942840996 | Cocetha Belton | Nurse Practitioner | 201 Copper Ridge Way, Florence, MS 39073-4601 | 2020-01-07 |
| Find all providers in zip 39073 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
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|---|---|---|---|---|
| 1720608045 | Daily Living Adc of Florence LLC | Clinic/Center | 500 Pamplico Hwy Ste F, Florence, SC 29505-6051 | 2020-04-17 |
| 1508148602 | Community Services of Northern Kentucky | Clinic/Center | 31 Spiral Dr, Florence, KY 41042-1351 | 2011-09-14 |
| 1063703676 | Community Services of Northern Kentucky | Clinic/Center | 31 Spiral Dr, Florence, KY 41042-1351 | 2011-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662626 | Hair Rehab | Clinic/Center | 313 Holland St, Anguilla, MS 38721-3872 | 2020-09-04 |
| 1326688185 | Brittney Debose | Clinic/Center | 16016 Lemoyne Blvd Apt 912, Biloxi, MS 39532-5186 | 2020-01-09 |
| 1720627599 | Ava Seniors Academy LLC | Clinic/Center | 2425 E. Alexander Street, Greenville, MS 38703 | 2019-12-27 |
| 1215575675 | The Abigayle Adult Day Care | Clinic/Center | 205 Industrial Cv, Ridgeland, MS 39157-2715 | 2019-12-17 |
| 1053977298 | Cal-wal Southern, LLC | Clinic/Center | 114 W Walker St, Greenville, MS 38701-4755 | 2019-05-14 |
| 1083171334 | Beverly Forrest-butts | Clinic/Center | 407 Nw Depot St, Durant, MS 39063-3705 | 2019-02-22 |
| 1023574183 | Quality Lives Assisted Living LLC | Clinic/Center | 226 Pauline St, Greenville, MS 38701-7012 | 2019-02-13 |
| 1619431210 | Deborah D Gibbs | Clinic/Center | 1403 S Broadway, Shelby, MS 38774 | 2019-01-28 |
| 1346712023 | Faith and Hope Adult Daycare | Clinic/Center | 737 N State St, Jackson, MS 39202-3006 | 2018-12-19 |
| 1013488923 | Covenant Adult Day Care of Tunica | Clinic/Center | 1041 Highway 61 S Ste 3, Tunica, MS 38676-9130 | 2018-12-17 |
| Find all providers with the same taxonomy | ||||
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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.