NPI 1811135718

Ellisville State School

Organisation Intellectual Disabilities Intermediate Care Facility Ellisville, MS

Practice location

Address: 1101 Hwy 11 S, Ellisville, MS 39437-4443
Phone: (601) 477-5770
Fax: (601) 477-5895

Authorised official

Name: Stephanie D. Smith
Title: Family Nurse Practitioner
Phone: (601) 477-5770

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence R865285 (MS)

Other Intermediate Care Facility, Intellectual Disabilities providers in Mississippi →

Registry record

NPI: 1811135718
Entity type: Organization
NPI issued: 30 Jan 2009
Record last updated: 30 Jan 2009

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.