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GRENADA LAKE MEDICAL CENTER
NPI 1144295965
Home Health in Grenada, MS

Active since February 23, 2006
960 AVENT DR, GRENADA, MS 38901(662) 227-7000(662) 227-7534 Get Directions Write a Review

NPPES record last updated: December 10, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Grenada Lake Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRENADA LAKE MEDICAL CENTER (NPI 1144295965) is a healthcare organization registered as a home health in Grenada, Mississippi and active in the NPI registry since February 2006. The organization lists Charles L Denton, Ceo, as its authorized official.

NPPES Registry Identity

NPI1144295965
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameGRENADA LAKE MEDICAL CENTER
Location Address960 AVENT DRGrenada, MS 38901-5230
Mailing Address960 Avent DrGrenada, MS 38901-5230 · (662) 227-7000 · Fax (662) 227-7534
Phone(662) 227-7000
Fax(662) 227-7534
Organization SubpartNo
Authorized OfficialCharles L DentonCeo · (662) 227-7005
Enumeration DateFebruary 23, 2006
Last NPPES UpdateDecember 10, 2007
✔ NPI 1144295965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in MS · 11245
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
960 AVENT DR, Grenada, MS 38901
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Other Identifiers 2

Medicaid00070502MS
Medicare ID-Type Unspecified257134MS · Medicare Provider

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Medicare Defined Swing Bed Unit
960 AVENT DR
GRENADA, MS 38901
Grenada County (662) 227-7000
DR. SARAH KATHERINE GANTZ PANNEL D.O
Psychiatry & Neurology (Psychiatry)
960 AVENT DR, UMC GRENADA SENIOR CARE UNIT
GRENADA, MS 38901
Grenada County (662) 227-7222
DR. TARENCE E WADE MD
Emergency Medicine
960 AVENT DR
GRENADA, MS 38901
Grenada County (662) 227-7172
GRENADA LAKE MEDICAL CENTER
Skilled Nursing Facility
960 AVENT DR
GRENADA, MS 38901
Grenada County (662) 227-7000
STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Psychiatric Hospital
960 AVENT DR
GRENADA, MS 38901
Grenada County (662) 227-7000
ANDREA JEMAE COLLINS M.D.
Hospitalist
960 AVENT DR
GRENADA, MS 38901
Grenada County (662) 227-7008
ROBERT KEITH DUBARD CRNA
Nurse Anesthetist, Certified Registered
960 AVENT DR
GRENADA, MS 38901
Grenada County (662) 227-7000
KALEB SMITH DNP, CRNA
Nurse Anesthetist, Certified Registered
960 AVENT DR
GRENADA, MS 38901
Grenada County (662) 227-7000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grenada Lake Medical Center's NPI number?

The NPI number for Grenada Lake Medical Center is 1144295965. It was assigned to this organization in the NPPES registry on February 23, 2006.

Where is Grenada Lake Medical Center located?

Grenada Lake Medical Center is located at 960 Avent Dr, Grenada, MS 38901. The listed phone number is (662) 227-7000.

What is Grenada Lake Medical Center's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

When was this NPI record last updated?

The NPPES record for Grenada Lake Medical Center was last updated on December 10, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.