1. Home
  2. Directory
  3. Mississippi
  4. Senatobia
  5. Assisted Living Facility
  6. NPI Profile

PROVIDENCE PCC OF SENATOBIA, LLC
NPI 1275849671
Assisted Living Facility in Senatobia, MS

Active since August 23, 2010CLIA 25D2193922 · Waiver
700 MOORES XING, SENATOBIA, MS 38668(662) 562-9229(662) 562-9202 Get Directions Write a Review

NPPES record last updated: August 23, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Providence Pcc Of Senatobia, Llc NPPES

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

PROVIDENCE PCC OF SENATOBIA, LLC (NPI 1275849671) is a healthcare organization registered as an assisted living facility in Senatobia, Mississippi and active in the NPI registry since August 2010. The organization holds a CLIA Waiver certificate valid through September 24, 2026 and lists Melanie Isaacks, Director, as its authorized official.

NPPES Registry Identity

NPI1275849671
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePROVIDENCE PCC OF SENATOBIA, LLC
Location Address700 MOORES XINGSenatobia, MS 38668-8004
Mailing Address700 Moores XingSenatobia, MS 38668-8004 · (662) 562-9229 · Fax (662) 562-9202
Phone(662) 562-9229
Fax(662) 562-9202
Organization SubpartNo
Authorized OfficialMelanie IsaacksDirector · (662) 562-9229
Enumeration DateAugust 23, 2010
✔ NPI 1275849671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MS · 1032
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
700 MOORES XING, Senatobia, MS 38668
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2193922

Providence Pcc Of Senatobia · Senatobia, MS
Active · expires Sep 24, 2026
CLIA Number25D2193922
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 25, 2024
Certificate Expiration DateSeptember 24, 2026
Laboratory DirectorLynette Beard
Laboratory Phone(662) 562-9229
Laboratory LocationProvidence Pcc Of Senatobia700 Moore's Crossing, Senatobia, MS 38668
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Providence Pcc Of Senatobia, LLC's NPI number?

The NPI number for Providence Pcc Of Senatobia, LLC is 1275849671. It was assigned to this organization in the NPPES registry on August 23, 2010.

Where is Providence Pcc Of Senatobia, LLC located?

Providence Pcc Of Senatobia, LLC is located at 700 Moores Xing, Senatobia, MS 38668. The listed phone number is (662) 562-9229.

What is Providence Pcc Of Senatobia, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Providence Pcc Of Senatobia, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2193922) is associated with this NPI, valid through September 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Pcc Of Senatobia, LLC was last updated on August 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.