GRACE AND MERCY PERSONAL CARE AND RESPITE SERVICE, LLC (NPI# 1790835635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790835635 |
| Entity Type | Organization |
| Organization Name | GRACE AND MERCY PERSONAL CARE AND RESPITE SERVICE, LLC |
| Other Organization Name | GENA'S FOUR SEASONS |
| Practice Address |
410 Masonic Drive Clinton MS 39056 |
| Mailing Address |
Po Box 374 Clinton MS 39060 |
| Practice Telephone | 6014884027 |
| Practice Fax Number | 6014884128 |
| Mailing Telephone | 6014884027 |
| Mailing Fax Number | 6014884128 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2018-12-18 |
| Authorized Official Name | SYLVIAETTE HARRIS (ADMINISTRATOR) |
| Authorized Official Telephone | 6014884027 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 376J00000X | Homemaker | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08778761 | 05 | |
| MS | 07680072 | 05 |
| Other Name | Type Code |
|---|---|
| GENA'S FOUR SEASONS | Former Legal Business Name - Organization |
| Street Address |
410 MASONIC DRIVE |
| City | CLINTON |
| State | MS |
| Zip Code | 39056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1225534530 | Magnolia Allergy Clinic LLC | Internal Medicine | 402 Cynthia St Ste E, Clinton, MS 39056 | 2018-04-04 |
| 1578093704 | Melinda A Weisenberger | Specialist/Technologist | 4600 W Northside Drive, Clinton, MS 39056 | 2017-06-20 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1023412822 | Rebecca Brooks Prewitt | Social Worker | 130 B Fairmont Street, Clinton, MS 39056 | 2014-10-22 |
| 1396184149 | Robert Joseph Hargis | Urology | 116 Afton Way, Clinton, MS 39056 | 2013-06-14 |
| 1750626321 | Clinton Dental Care, Inc. | Dentist | 736 Clinton Pkwy, Clinton, MS 39056 | 2012-12-07 |
| 1922394469 | Daphenia C. Knight Starling | Nurse Practitioner | Clinton Healthcare, 1251 Pinehaven Rd, Clinton, MS 39056 | 2011-06-23 |
| 1134443385 | Gwendolyn Coleman Garror | Pharmacist | 132 Fairmount Drive, Clinton, MS 39056 | 2010-03-17 |
| Find all providers in zip 39056 | ||||
| Taxonomy Code | 376J00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Homemaker |
| An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards. |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011682 | Tiffany Denice Redd | Homemaker | 15092 S Jackson St, Durant, MS 39063-3900 | 2020-10-23 |
| 1952924763 | Southern Touch Homemaker & Comfort Agency LLC | Homemaker | 501a Lumberton Rd, Columbia, MS 39429-3515 | 2020-05-27 |
| 1831710714 | Annette Santiago | Homemaker | 2019 Springwood Rd, Gautier, MS 39553-7301 | 2020-05-01 |
| 1548895261 | More Than Help Healthcare Services LLC | Homemaker | 124 Carriage Ln, Florence, MS 39073-6015 | 2020-03-04 |
| 1467083907 | Ratoya Walker | Homemaker | 34 Jims Rd, Columbia, MS 39429-8265 | 2020-02-03 |
| 1982249702 | Patricia A Holloway | Homemaker | 115 S Pearl St, Carthage, MS 39051-4131 | 2019-11-15 |
| 1124662531 | Dorothy M Moore | Homemaker | 2211 Highway 45 N Ste G2211, Meridian, MS 39301-2730 | 2019-10-30 |
| 1912548181 | Tammy S Ramsey | Homemaker | 4653 Highway 15 N, Laurel, MS 39443-9473 | 2019-09-30 |
| 1780232801 | Kimberly Thompson | Homemaker | 230 Sawyer Rd, Winona, MS 38967-9504 | 2019-09-02 |
| 1376103408 | Deneitra Jones | Homemaker | 131 Bainbridge Xing, Canton, MS 39046-6031 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
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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.