LEAKE EXTENDED CARE FACILITY - NPI 1750456034 - Nursing Facility/Intermediate Care Facility in Carthage, MS

Q: What is Leake Extended Care Facility's NPI number?

The NPI number for Leake Extended Care Facility is 1750456034. It was assigned to this organization in the NPPES registry on November 21, 2006.

Q: What is Leake Extended Care Facility's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

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About Leake Extended Care Facility NPPES

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

LEAKE EXTENDED CARE FACILITY (NPI 1750456034) is a healthcare organization registered as a nursing facility/intermediate care facility in Carthage, Mississippi and active in the NPI registry since November 2006. The organization lists Sandy Goolsby, Accountant Business Office Manager, as its authorized official.

NPPES Registry Identity

NPI1750456034

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameLEAKE EXTENDED CARE FACILITY

Location Address310 ELLIS STCarthage, MS 39051-3809

Mailing Address310 Ellis StCarthage, MS 39051-3809 · (601) 267-1100 · Fax (601) 267-1211

Phone(601) 267-1100

Fax(601) 267-1211

Organization SubpartNo

Authorized OfficialSandy GoolsbyAccountant Business Office Manager · (601) 267-1100

Enumeration DateNovember 21, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1750456034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities

Taxonomy Code313M00000X

License✔ Licensed in MS · 214

Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

310 ELLIS ST, Carthage, MS 39051

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Other Identifiers 1

Medicaid00230186MS

Other Providers at the Same Location NPPES 6

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

MRS. TOMMIE K JONES C.F.N.P.

Nurse Practitioner (Family)