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PROVIDENCE PCC OF GRENADA, LLC
NPI 1477869881
Assisted Living Facility in Grenada, MS

Active since August 23, 2010
1855 HILL DR, GRENADA, MS 38901(662) 226-8556(662) 229-0556 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 Grenada, Llc NPPES

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

PROVIDENCE PCC OF GRENADA, LLC (NPI 1477869881) is a healthcare organization registered as an assisted living facility in Grenada, Mississippi and active in the NPI registry since August 2010. The organization lists Debbie P Mitchell, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1477869881
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePROVIDENCE PCC OF GRENADA, LLC
Location Address1855 HILL DRGrenada, MS 38901-5003
Mailing Address1855 Hill DrGrenada, MS 38901-5003 · (662) 226-8556 · Fax (662) 229-0556
Phone(662) 226-8556
Fax(662) 229-0556
Organization SubpartNo
Authorized OfficialDebbie P MitchellExecutive Director · (662) 226-8556
Enumeration DateAugust 23, 2010
✔ NPI 1477869881 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 · 777
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.
1855 HILL DR, Grenada, MS 38901
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Other Providers at the Same Location NPPES

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

MR. WALLACE EDGAR CRESSWELL P.T.
Physical Therapist
1855 HILL DR
GRENADA, MS 38901
Grenada County (662) 809-3339

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 Grenada, LLC's NPI number?

The NPI number for Providence Pcc Of Grenada, LLC is 1477869881. It was assigned to this organization in the NPPES registry on August 23, 2010.

Where is Providence Pcc Of Grenada, LLC located?

Providence Pcc Of Grenada, LLC is located at 1855 Hill Dr, Grenada, MS 38901. The listed phone number is (662) 226-8556.

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

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

When was this NPI record last updated?

The NPPES record for Providence Pcc Of Grenada, 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 16 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.