Ellisville State School

LBN: Ellisville State School
Ellisville State School is an health care organization with primary practice located at 1101 Hwy 11 S , Ellisville MS 39437-4443. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Ellisville State School can be contacted via phone (601) 477-5607, or through Brett, Rene'E via phone (601) 477-5595.

Contact Information

Primary practice address
1101 Hwy 11 S Ellisville MS 39437-4443
Phone: (601) 477-5607
Fax: (601) 477-5700
Website:
Map and Directions
Authorized official contact:
Name: Brett, Rene'E
Phone: (601) 477-5595

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1285947408
LBN Legal business name Ellisville State School
DBA Doing business as
Authorized official Brett, Rene'E
Entity Organization
Organization subpart 1 No
Enumeration date Jul 16th, 2010
Last updated Jan 27th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285947408 NPPES
Mississippi MEDICAID 05850722

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