| Organization Name: | SHIRLEY'S ASSISTED LIVING |
| NPI Number: | 1316227580 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHIRLEY MONROE (OWNER) |
| Mailing Address: | 1000 Bb King Rd Indianola |
| State: | MS US |
| Postal Code: | 387513606 |
| Phone Number: | 6628873000 |
| Fax Number: | 6628873500 |
| NPI Enumeration Date: | 08/19/2011 |
| NPI Last Update Date: | 08/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3104A0625X |
| License Number: | 1014 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | Assisted Living, Mental Illness |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |