AMANDA ELIZABETH DEROUSSE (NPI# 1669037701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669037701 |
| Entity Type | Individual |
| Full Name | AMANDA ELIZABETH DEROUSSE |
| Practice Address |
1527 Deerwood Dr Jackson MO 63755-4148 |
| Practice Telephone | 5732250580 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Street Address |
1527 DEERWOOD DR |
| City | JACKSON |
| State | MO |
| Zip Code | 63755-4148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1215438585 | The Villas of Jackson LLC | Assisted Living Facility | 670 Broadridge, Jackson, MO 63755 | 2018-02-22 |
| 1346637865 | Vitality Clinic | Health Educator | 111 N. Missouri Street, Jackson, MO 63755 | 2015-04-22 |
| 1144569567 | Rock Care In Home Services, LLC | Nursing Care | 204 S Union Ave, Jackson, MO 63755 | 2013-02-05 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1154689321 | Benjamin Gail Goodier | Dentist | 3100 East Jackson Blvd., Jackson, MO 63755 | 2012-04-25 |
| 1912278987 | Guardian Angels Homecare, LLC | Nursing Care | 1335 Old Cape Rd., Suite F, Jackson, MO 63755 | 2012-01-23 |
| 1528357829 | Sydney Nicole Cheek | Technician, Other | 107 Cottonwood St., Jackson, MO 63755 | 2011-04-07 |
| 1215162920 | Troy L Bell Od & Associates, PC | Optometrist | 2594 E Jackson Blvd, Jackson, MO 63755 | 2009-05-26 |
| 1932398021 | Immediate Healthcare, Inc. | General Practice | 1508 Edgemont Blvd, Perryville, MO 63755 | 2007-10-15 |
| Find all providers in zip 63755 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134617350 | Golden Moments Home Care, LLC | Day Training, Developmentally Disabled Services | 201 Airways Blvd, Jackson, TN 38301-5800 | 2018-04-24 |
| 1144752874 | Robert Zangrillo | Day Training, Developmentally Disabled Services | 7 Bailey Ct, Jackson, NJ 08527-4459 | 2017-03-31 |
| 1235679523 | Doris C. Bridges | Day Training, Developmentally Disabled Services | 3928 Allen Dr, Jackson, MS 39212-5379 | 2017-03-06 |
| 1366995110 | Senior Services, LLC | Day Training, Developmentally Disabled Services | 21 Northtown Dr, Jackson, MS 39211-3016 | 2016-07-28 |
| 1891064002 | Tennessee Personal Assistance, Inc | Day Training, Developmentally Disabled Services | 31b Bowling Dr, Jackson, TN 38305-6100 | 2011-12-16 |
| 1508150160 | Never Forgotten Ministries | Day Training, Developmentally Disabled Services | 1122 Fincherville Rd, Jackson, GA 30233-3433 | 2011-06-01 |
| 1952526774 | Sitters & More, Inc. | Day Training, Developmentally Disabled Services | 125 Stonebridge Blvd Ste A, Jackson, TN 38305-2159 | 2007-04-16 |
| 1710012000 | Lifetime Potentials, Inc. | Day Training, Developmentally Disabled Services | 43 Lj Lane, Jackson, KY 41339 | 2007-02-23 |
| 1902931314 | Madison Haywood County Developmental Services, Inc | Day Training, Developmentally Disabled Services | 38 Garland Dr, Jackson, TN 38305-3602 | 2007-02-23 |
| 1639223852 | A.r.e. Inc., of Jackson | Day Training, Developmentally Disabled Services | 1009 W Michigan Ave, Jackson, MI 49202-4120 | 2007-01-23 |
| Find all providers in JACKSON | ||||
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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.