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JESSIE MAE'S SUPPORTED LIVING, LLC
NPI 1508663923
Assisted Living Facility - Assisted Living, Behavioral Disturbances in Suffolk, VA

Active since February 25, 2025
614 ROOSEVELT DR, SUFFOLK, VA 23434(757) 967-1062(757) 801-5375 Get Directions Write a Review

NPPES record last updated: February 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jessie Mae's Supported Living, Llc NPPES

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

JESSIE MAE'S SUPPORTED LIVING, LLC (NPI 1508663923) is a healthcare organization registered as an assisted living, behavioral disturbances in Suffolk, Virginia and active in the NPI registry since February 2025. The organization lists Lynnette Cross-mack, Owner, as its authorized official.

NPPES Registry Identity

NPI1508663923
Entity TypeOrganization
Primary Taxonomy3104A0630X
Legal Business NameJESSIE MAE'S SUPPORTED LIVING, LLC
Location Address614 ROOSEVELT DRSuffolk, VA 23434-3348
Mailing Address23069 Retreat LnCarrollton, VA 23314-4192 · (757) 967-1062 · Fax (757) 801-5375
Phone(757) 967-1062
Fax(757) 801-5375
Organization SubpartNo
Authorized OfficialLynnette Cross-mackOwner · (757) 967-1062
Enumeration DateFebruary 25, 2025
NPPES CertifiedFebruary 25, 2025
✔ NPI 1508663923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Behavioral DisturbancesNursing & Custodial Care Facilities
Taxonomy Code3104A0630X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.
614 ROOSEVELT DR, Suffolk, VA 23434
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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 Jessie Mae's Supported Living, LLC's NPI number?

The NPI number for Jessie Mae's Supported Living, LLC is 1508663923. It was assigned to this organization in the NPPES registry on February 25, 2025.

Where is Jessie Mae's Supported Living, LLC located?

Jessie Mae's Supported Living, LLC is located at 614 Roosevelt Dr, Suffolk, VA 23434. The listed phone number is (757) 967-1062.

What is Jessie Mae's Supported Living, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Behavioral Disturbances, with taxonomy code 3104A0630X.

When was this NPI record last updated?

The NPPES record for Jessie Mae's Supported Living, LLC was last updated on February 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.