Organization Name: | METHODIST HOME ROAD LIVING CENTER |
NPI Number: | 1245663251 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PEBLES JONES-WRIGHT (MANAGER/OWNER) |
Mailing Address: | 4560 Methodist Home Road Jackson |
State: | MS US |
Postal Code: | 39213 |
Phone Number: | 7692577232 |
Fax Number: | 7692577745 |
NPI Enumeration Date: | 08/13/2013 |
NPI Last Update Date: | 08/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | P321453 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |