NPI 1497144265

Emmanuel Ridge of Louisville Ms INC

Organisation PACE Provider Organization Louisville, MS

Practice location

Address: 803 W Main St, Louisville, MS 39339-2539
Phone: (662) 705-5031
Fax: (662) 705-5034
Mailing address: 750 Boling St Suite H, Jackson, MS 39209-2652

Authorised official

Name: Beatrice a Ezem
Title: Ceo
Phone: (601) 927-9839

Registered specialties (3)

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence 08752218 (MS)

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Mississippi →

Administrator Registered Nurse

Nursing Service Providers Taxonomy 163WA2000X Licence R815521 (MS)

Other Registered Nurse providers in Mississippi →

In Home Supportive Care Agency

Agencies Taxonomy 253Z00000X Licence 03630719 (MS)

Other In Home Supportive Care providers in Mississippi →

Registry record

NPI: 1497144265
Entity type: Organization
NPI issued: 16 Jan 2015
Record last updated: 16 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.