NPI 1528359189

Shanell's Residential Care Home, INC.

Organisation Assisted Living Facility Jackson, MS

Practice location

Address: 4022 California Ave, Jackson, MS 39213-5513
Phone: (601) 362-4549
Mailing address: PO Box 83040, Jackson, MS 39283-3040

Authorised official

Name: Carnell Kitchens
Title: President
Phone: (601) 259-4602

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 1035 (MS)

Other Assisted Living Facility providers in Mississippi →

Registry record

NPI: 1528359189
Entity type: Organization
NPI issued: 29 Apr 2011
Record last updated: 29 Apr 2011

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.