MRS. YOLANDA H. JACKSON (NPI# 1740626290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740626290 |
| Entity Type | Individual |
| Full Name | MRS. YOLANDA H. JACKSON |
| Practice Address |
512 Thomas St. Boyle MS 38730 |
| Practice Telephone | 6625454867 |
| Mailing Telephone | 6635454867 |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2013-05-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | MS | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 38730 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332074 | Yolanda Letrice Jackson | Dietitian, Registered | 1024 Greendale Rd Unit 14103, Lexington, KY 40511-8350 | 2020-06-25 |
| 1144739087 | Yolanda Jackson | Home Health Aide | 2987 Atwater Dr, Cincinnati, OH 45251-2251 | 2017-09-22 |
| 1073904587 | Yolanda Trenett Jackson | Physical Therapy Assistant | 400 Embassy Row, Suite 125, Atlanta, GA 30328-1667 | 2015-02-05 |
| 1427269760 | Yolanda Jackson | Case Manager/Care Coordinator | 10103 Skiff Cir, Anchorage, AK 99515-2578 | 2007-05-25 |
| 1932311362 | Yolanda Deneen Jackson | Psychologist | 1214 Whispering Pines Rd, Albany, GA 31707-3562 | 2007-05-06 |
| Street Address |
512 THOMAS ST. |
| City | BOYLE |
| State | MS |
| Zip Code | 38730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497194831 | Wisdom Adult Day Center | Point of Service | 162 T M Jones Hwy, Boyle, MS 38730-2005 | 2013-06-19 |
| 1124405840 | Willie Mae Clerk Adult Day Care,llc | Clinic/Center | 151 Gaines Hwy, Boyle, MS 38730-9512 | 2015-05-01 |
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417292137 | Family First Adult Daycare LLC | PACE Provider Organization | 112 Scotland Cir, Hattiesburg, MS 39401-8326 | 2012-12-06 |
| 1407118698 | G.h.c. Incorporated | PACE Provider Organization | 548 Rosemary Rd Ste C, Cleveland, MS 38732-2075 | 2012-06-13 |
| 1861836132 | Restorations Adult Daycare | PACE Provider Organization | 1766 Old Leland Rd, Greenville, MS 38703 | 2013-04-17 |
| 1225374903 | Parental Adult Daycare | PACE Provider Organization | 215 W Main St, Marks, MS 38646-1136 | 2012-12-27 |
| 1093071300 | Metroplex Center, LLC | PACE Provider Organization | 312 Green St, Hattiesburg, MS 39401-3758 | 2012-04-11 |
Please comment or provide details below to improve the information on MRS. YOLANDA H. JACKSON.
| 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.