WILLOWOOD DEVELOPMENTAL CENTER (NPI# 1831243070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831243070 |
| Entity Type | Organization |
| Organization Name | WILLOWOOD DEVELOPMENTAL CENTER |
| Practice Address |
1635 Boling St Jackson MS 39213-4418 |
| Practice Telephone | 6013660123 |
| Mailing Telephone | 6013660123 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2010-01-27 |
| Authorized Official Name | MR. CURTIS E. ALFORD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6013660123 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09015618 | 05 | |
| MS | 00770062 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174991855 | Willowood Developmental Center | Day Training, Developmentally Disabled Services | 1635 Boling St, Jackson, MS 39213-4418 | 2015-09-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WILLOWOOD DEVELOPMENTAL CENTER INC | 1635 Boling St, Jackson, MS 39213-4418 |
| Street Address |
1635 BOLING ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821188285 | Deborah G Monsour | Speech-Language Pathologist | 1635 Boling St, Jackson, MS 39213-4418 | 2006-10-13 |
| 1619599677 | Karen Jane Day | Registered Nurse | 1635 Boling St, Jackson, MS 39213-4418 | 2020-05-13 |
| 1174991855 | Willowood Developmental Center | Day Training, Developmentally Disabled Services | 1635 Boling St, Jackson, MS 39213-4418 | 2015-09-11 |
| 1942437595 | Whitney Herron Nesbit | Occupational Therapist | 1635 Boling St, Jackson, MS 39213-4418 | 2009-06-22 |
| 1225209489 | Kecia Spencer Ray | Specialist | 1635 Boling St, Jackson, MS 39213-4418 | 2008-03-17 |
| 1326219585 | Stephanie Pieroni Oliver | Speech-Language Pathologist | 1635 Boling St, Jackson, MS 39213-4418 | 2008-03-17 |
| 1326199787 | Owen Mullen | Specialist/Technologist | 1635 Boling St, Jackson, MS 39213-4418 | 2007-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922650365 | Enable Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12 Thompson Bridge Rd, Jackson, NJ 08527-4618 | 2019-07-16 |
| 1912383779 | Mississippi Health Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 W Amite St, Jackson, MS 39201-1203 | 2015-08-04 |
| 1053742684 | Building Futures, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 220 Mcdowell Park Cir, Jackson, MS 39204-4317 | 2013-12-08 |
| 1225366313 | Genesis Homes of Jackson Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6853 Hague Ave, Jackson, MI 49201-8334 | 2009-11-30 |
| 1831347038 | Buckeye Community Services, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6 W South St, Jackson, OH 45640-1504 | 2008-09-03 |
| 1760668198 | Residential Loving Care Group Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2924 Bryantown Road, 105 West Main Street, Ahoskie, Nc 27910, Jackson, NC 27845-0000 | 2008-01-16 |
| 1841312543 | Catholic Charities, Diocese of Metuchen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 384 Vath St, Jackson, NJ 08527-5216 | 2007-04-04 |
| 1316085558 | Christ Centered Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 327 W Monroe St, Jackson, MI 49202-2253 | 2007-02-01 |
| 1164569802 | Pdhcrc, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 205 17th St, Jackson, MI 49203-1403 | 2007-01-31 |
| 1184778805 | Twin Maples | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 158 Robinson Rd, Jackson, MI 49203-1053 | 2007-01-22 |
| 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.