DESOTO PEDIATRIC EXTENDED CARE LLC


Address: 750 Stateline Road East, Southhaven, MS 38671
Phone: 6624681320

DESOTO PEDIATRIC EXTENDED CARE LLC (NPI# 1538526140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538526140
Entity Type Organization
Organization Name DESOTO PEDIATRIC EXTENDED CARE LLC
Practice Address 750 Stateline Road East
Southhaven
MS 38671
Mailing Address Po Box 2994
Monroe
LA 71207-2994
Practice Telephone 6624681320
Enumeration Date 2016-01-27
Last Update Date 2016-01-27
Authorized Official Name MAUREEN GALLAGHER (OWNER)
Authorized Official Telephone 3185129218
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3140N1450X Skilled Nursing Facility
Specialization: Nursing Care, Pediatric
Nursing & Custodial Care Facilities

Office Location

Street Address 750 STATELINE ROAD EAST
City SOUTHHAVEN
State MS
Zip Code 38671

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285196196 Emma Tinsley-bowles Long Social Worker 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 2019-04-01
1851847586 Tiffany Lashea Jones Adult Companion 8755 Millbranch Road, Southaven, MS 38671 2016-09-01
1073983052 Tara Burt Physical Therapist 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 2015-10-02
1295160463 Ideal Community Care,llc In Home Supportive Care 8869 Centre Str #3, Southaven, MS 38671 2013-09-06
1578995692 Gregory Charles Eakins Jr. Optometrist 338 Goodman Rd West, Southaven, MS 38671 2013-07-31
1295173169 Erica R. Martin Social Worker 975 Swinnea Rdg Ste 3, Southaven, MS 38671 2013-06-12
1386918431 Freds Stores of Tennessee Inc Pharmacy 710 Church Road, Southaven, MS 38671 2012-03-06
1740565613 Mary Jeanette Scruggs Pharmacist 1011 Goodman Rd, Southaven, MS 38671 2011-10-11
1184919268 First Pharmacy Services 5 Pharmacy 5185a Getwell Rd, Southaven, MS 38671 2011-06-16
1295028207 First Call Ambulance Service, LLC Ambulance 240 Stateline Road West, Southaven, MS 38671 2011-05-24
Find all providers in zip 38671

Taxonomy Information

Taxonomy Code 3140N1450X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility
Specialization Nursing Care, Pediatric

Taxonomy Definition

A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1043858053 Pediatric Haven Skilled Nursing Facility 112 Westfalen Drive, Canton, MS 39046 2019-12-20
1588104814 Jackson County Pediatric Extended Care LLC Skilled Nursing Facility 2025 Jackson Ave, Pascagoula, MS 39567-4427 2017-03-06
1801256318 Caring Hands Ppec of Vicksburg, LLC Skilled Nursing Facility 3419 Wisconsin Ave, Vicksburg, MS 39180-5330 2016-02-25
1609259936 Meridian Pediatric Extended Care LLC Skilled Nursing Facility 3850 Highway 45 N, Meridian, MS 39301-1517 2015-07-06
1093198731 Caring Hands Prescribed Pediatric Skilled Nursing Facility 371 Towne Center Pl, Ridgeland, MS 39157-4833 2015-06-30
1538249792 Memorial Hospice Inc Skilled Nursing Facility 600 Ohio Street, Clarksdale, MS 38614 2006-10-16
1639606940 Pediatrust Columbus, LLC Skilled Nursing Facility 306 Hospital Dr, Columbus, MS 39705-1935 2017-05-17
1437523511 Delta Pediatric Care Skilled Nursing Facility 526 Fairview Ave, Greenville, MS 38701-5401 2015-11-30
1891107298 Gulf Coast Pediatric Care LLC Skilled Nursing Facility 1285 Spring St, Gulfport, MS 39507-3423 2014-05-20

Competitor

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City SOUTHHAVEN
Zip Code 38671

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Dataset Information

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.

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