JACQUELINE HANNAH (NPI# 1528447471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528447471 |
| Entity Type | Individual |
| Full Name | JACQUELINE HANNAH |
| Practice Address |
924 Broadmoor Dr Indianola MS 38751-3608 |
| Practice Telephone | 6622079842 |
| Mailing Telephone | 6622079842 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2017-03-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
MS | Ambulatory Health Care Facilities | |
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities |
| Street Address |
924 BROADMOOR DR |
| City | INDIANOLA |
| State | MS |
| Zip Code | 38751-3608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194252494 | Elise's Place Adc | Clinic/Center | 924 Broadmoor Dr, Indianola, MS 38751-3608 | 2017-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649781253 | Greater Hearts Adult Daycare | Clinic/Center | 124 Curtis Street, Indianola, MS 38751 | 2017-10-23 |
| 1083139505 | Quality Family Care LLC | Nurse Practitioner | 310 Hwy 82 West, Suite D, Indianola, MS 38751 | 2017-08-05 |
| 1932641800 | Creative Image Personal Care Services LLC | Respite Care | 503 Hwy 82 East, Indianola, MS 38751 | 2016-11-09 |
| 1225580442 | St. John's Respite Care Services, LLC | In Home Supportive Care | 517 East Street, Indianola, MS 38751 | 2016-11-04 |
| 1992163588 | Rona Kaye Huey | Nurse Practitioner | 310 Highway 82 W Ste D, Indianola, MS 38751 | 2016-02-10 |
| 1952641201 | Julia R. Hill, Dmd, Pa | Dentist | 104 W. Gresham St., Indianola, MS 38751 | 2013-02-25 |
| 1649463977 | Kenneth C Beal Jr. | Dentist | 913 B.b. King Road, Indianola, MS 38751 | 2007-08-21 |
| 1922136688 | Lloyd Leon Patton Jr. | Pharmacist | 903 Highway 82 East, Building G, Indianola, MS 38751 | 2007-03-02 |
| 1770623506 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | 110 East Baker Street, Indianola, MS 38751 | 2007-02-08 |
| 1548311525 | Quality In Home Services Inc | Homemaker | 108 Martin Luther King, Indianola, MS 38751 | 2007-01-16 |
| Find all providers in zip 38751 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669086591 | Justlikehome Supportive Living LLC | Assisted Living Facility | 9 County Road 3312, Enterprise, MS 39330-9070 | 2020-09-08 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1851661938 | Saint Francis Community Services In Mississippi Inc | Assisted Living Facility | 503 Seal St, Apt #7, Picayune, MS 39466-5386 | 2012-01-06 |
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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.