National Provider Identifier Database

METHODIST HOME ROAD LIVING CENTER
Licensed Practical Nurse

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.


Contact Information

METHODIST HOME ROAD LIVING CENTER
4560 METHODIST HOME ROAD
JACKSON, MS39213
Phone: 769-257-7232
Fax: 769-257-7745
Website:
Specialty Taxonomy Code
* Licensed Practical Nurse 164W00000X

* Indicates primary specialty

NPI Profile & details for METHODIST HOME ROAD LIVING CENTER

NPI Number 1245663251
Legal business name
LBN
METHODIST HOME ROAD LIVING CENTER
Authorized official PEBLES JONES-WRIGHT - (MANAGER/OWNER)
Entity Organization
Organization subpart Yes
Enumeration date 08/13/2013
Last updated 08/13/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • MS License #: P321453
  • MS Other: 078890066 DUNS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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