Assisted/Extended Stay Facility
LBN: Emmanuel Ridge Housing Inc
Assisted/Extended Stay Facility is an health care organization with primary practice located at 803 W Main St , Louisville MS 39339-2539. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Adult Care Home. Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty.
Emmanuel Ridge Housing Inc can be contacted via phone (662) 705-5031, or through Ezem, Beatrice A via phone (601) 927-9839.
Contact Information
Primary practice address
803 W Main St
Louisville MS 39339-2539
Phone: (662) 705-5031
Fax: (662) 705-5034
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Assisted Living Facility | 310400000X | Mississippi | |
| Nursing & Custodial Care Facilities / Adult Care Home | 311ZA0620X | Mississippi |
Profile Details
| NPI number | 1033508809 |
|---|---|
| LBN Legal business name | Emmanuel Ridge Housing Inc |
| DBA Doing business as | Assisted/Extended Stay Facility |
| Authorized official | Ezem, Beatrice A RN,CM,CLNC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 17th, 2015 |
| Last updated | Jan 17th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033508809 | NPPES |
| Mississippi | MEDICAID | 08762218 | |
| Mississippi | MEDICAID | 03630719 | |
| Mississippi | MEDICAID | 07123515 |
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