PEACE WELLNESS MOBILE UNIT (NPI# 1770019036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770019036 |
| Entity Type | Organization |
| Organization Name | PEACE WELLNESS MOBILE UNIT |
| Practice Address |
502 Mulberry St Rear Bldg Vaiden MS 39176-9648 |
| Practice Telephone | 6012927015 |
| Practice Fax Number | 8668846508 |
| Mailing Telephone | 6012927015 |
| Mailing Fax Number | 8668846508 |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2017-05-05 |
| Authorized Official Name | TRACY PEEPLES (OWNER) |
| Authorized Official Telephone | 6012927015 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09753895 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831460591 | Peace Wellness Mobile Unit | Early Intervention Provider Agency | 638 Northwest Ave, Durant, MS 39063-3337 | 2012-01-25 |
| Street Address |
502 MULBERRY ST REAR BLDG |
| City | VAIDEN |
| State | MS |
| Zip Code | 39176-9648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538411129 | Peace Wellness Center LLC | Registered Nurse | 502 Mulberry St, Vaiden, MS 39176-9648 | 2012-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255757233 | Caring Hearts Home Care LLC | Nursing Care | 374 County Road 48, Vaiden, MS 39176-5047 | 2014-03-13 |
| 1144210394 | Clc of Vaiden, LLC | Skilled Nursing Facility | 868 Mulberry St, Vaiden, MS 39176-5385 | 2005-10-27 |
| 1023522448 | Courtney Williams | Occupational Therapist | 868 Mulberry St, Vaiden, MS 39176-5385 | 2017-11-21 |
| 1336520824 | Anna King | Speech-Language Pathologist | 868 Mulberry St, Vaiden, MS 39176-5385 | 2015-06-10 |
| 1023321254 | Georgianna Tappa | Occupational Therapy Assistant | 868 Mulberry St, Vaiden, MS 39176-5385 | 2010-07-16 |
| 1942513221 | Amber Shannon Joiner | Speech-Language Pathologist | 868 Mulberry St, Vaiden, MS 39176-5385 | 2010-07-15 |
| 1053439133 | Mallory Community Health | Clinic/Center | 201a Magnolia St, Vaiden, MS 39176-5644 | 2007-03-27 |
| 1841727971 | State of Mississippi- University of Mississippi Medical Center | Clinic/Center | 201a Magnolia St, Vaiden, MS 39176-5644 | 2017-05-19 |
| 1255571980 | Rava Pittman | Nurse Practitioner | 201a Magnolia St, Vaiden, MS 39176-5644 | 2009-02-20 |
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467842641 | Crossroads Adult Day Care | Nursing Facility/Intermediate Care Facility | 519 S Church St, Brookhaven, MS 39601-3807 | 2015-01-27 |
| 1699108860 | Holistic Geriatric Care LLC | Nursing Facility/Intermediate Care Facility | 10026 Lizelia Rd, Meridian, MS 39305-9595 | 2013-08-12 |
| 1538492111 | Iva Ward LLC | Nursing Facility/Intermediate Care Facility | 711 Melrose Montebello Pkwy, Natchez, MS 39120-4924 | 2009-09-14 |
| 1295961969 | River Oaks Management, LLC | Nursing Facility/Intermediate Care Facility | 501 Highway 80 E, Brandon, MS 39042-3257 | 2009-06-08 |
| 1063697340 | North Bolivar School District | Nursing Facility/Intermediate Care Facility | 615 School Street, Duncan, MS 38740 | 2008-01-04 |
| 1659555761 | Tallahatchie General Hospital and Extended Care Facility | Nursing Facility/Intermediate Care Facility | 201 South Market Street, Charleston, MS 38921 | 2007-12-26 |
| 1568683498 | Whitfield Nursing Home, Inc. | Nursing Facility/Intermediate Care Facility | 2101 Proper St, Corinth, MS 38834-5247 | 2007-05-01 |
| 1265656391 | Gilberto Patino | Nursing Facility/Intermediate Care Facility | 419 Elizabeth Drive, Leakesville, MS 39451 | 2007-04-12 |
| 1013048453 | Bruce Nursing Center, Inc. | Nursing Facility/Intermediate Care Facility | 176 Hwy 9 South, Bruce, MS 38915 | 2007-03-08 |
| 1326178203 | Smith County Ltc, LLC | Nursing Facility/Intermediate Care Facility | 309 Magnolia Drive, Raleigh, MS 39153 | 2007-03-07 |
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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.