PREFERRED CARE DEVELOPMENTAL CENTERS OF MS I, INC. (NPI# 1710969787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710969787 |
| Entity Type | Organization |
| Organization Name | PREFERRED CARE DEVELOPMENTAL CENTERS OF MS I, INC. |
| Other Organization Name | DELTA MANOR |
| Practice Address |
701 Highway 322 Clarksdale MS 38614-4722 |
| Mailing Address |
5420 W Plano Pkwy Plano TX 75093-4823 |
| Practice Telephone | 6626272212 |
| Practice Fax Number | 6626271727 |
| Mailing Telephone | 9729313800 |
| Mailing Fax Number | 9727676222 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2011-08-04 |
| Authorized Official Name | MRS. JAMIE LATTURE COLLIER (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 9729313800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 631 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00220056 | 05 |
| Other Name | Type Code |
|---|---|
| Delta Manor | Doing Business As Name - Organization |
| Street Address |
701 HIGHWAY 322 |
| City | CLARKSDALE |
| State | MS |
| Zip Code | 38614-4722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1700226123 | Nikki Nikkia Cager | Internal Medicine | 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 | 2013-06-29 |
| 1205186947 | Celestial Comfort Care Hospice | Hospice Care, Community Based | 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 | 2012-09-10 |
| 1063667129 | The Smile Center of Clarksdale | Clinic/Center | 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 | 2008-11-17 |
| 1801060033 | Clarksdale Municipal School District | Local Education Agency (LEA) | Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 | 2008-04-18 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1114040367 | William F Wilson Jr. | Dentist | 850 Desoto Ave, Extended, Clarksdale, MS 38614 | 2007-04-10 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| 1497888457 | Carole L Mangrem | Pediatrics | 2245 N Starte St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers in zip 38614 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578703583 | F Lee Neal Jr Md Pa | Intermediate Care Facility, Mentally Retarded | 717 S Church St, Brookhaven, MS 39601-3811 | 2009-03-03 |
| 1750448718 | Hudspeth Regional Center | Intermediate Care Facility, Mentally Retarded | Highway 475 South, Whitfield, MS 39193 | 2007-01-02 |
| 1326068834 | Boswell Regional Center | Intermediate Care Facility, Mentally Retarded | 1049 Simpson Highway 149 South, Magee, MS 39111-0128 | 2006-07-20 |
| 1033143284 | South Mississippi Regional Center | Intermediate Care Facility, Mentally Retarded | 1170 W Railroad St, Long Beach, MS 39560-4106 | 2006-07-11 |
| 1346222163 | Preferred Care Developmental Centers of Ms I Inc | Intermediate Care Facility, Mentally Retarded | 200 Womack St, Starkville, MS 39759-2232 | 2005-11-17 |
| 1174505010 | Preferred Care Developmental Centers of Ms I Inc | Intermediate Care Facility, Mentally Retarded | 524 Brookman Dr, Brookhaven, MS 39601-2384 | 2005-11-16 |
| 1659353688 | Preferred Care Developmental Centers of Ms I Inc | Intermediate Care Facility, Mentally Retarded | 1145 Tisdale Ave, Canton, MS 39046-4965 | 2005-11-16 |
| 1346234184 | Hudspeth Center Pharmacy | Intermediate Care Facility, Mentally Retarded | Highway 475, Whitfield, MS 39193 | 2005-09-08 |
| 1275901167 | Baptist Homes Inc | Intermediate Care Facility, Mentally Retarded | 461 Goodloe Rd, Canton, MS 39046-9740 | 2015-09-09 |
| 1316377633 | Hudspeth Regional Center | Intermediate Care Facility, Mentally Retarded | 100 Hudspeth Center Drive, Whitfield, MS 39193 | 2013-11-22 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSDALE |
| Zip Code | 38614 |
Please comment or provide details below to improve the information on PREFERRED CARE DEVELOPMENTAL CENTERS OF MS I, INC..
| 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.