OrganizationActive
Providence Pcc of Grenada, LLC
NPI 1477869881 · Assisted Living Facility · Grenada, MS
Provider details
- NPI number
- 1477869881
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Debbie Mitchell, Executive Director(662) 226-8556
- License
- 777 (MS)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1855 Hill Dr
Grenada, MS 38901-5003
Phone: (662) 226-8556
Fax: (662) 229-0556
Street-level locationGet directions
Mailing address
1855 Hill Dr
Grenada, MS 38901-5003
Registry dates
- Enumerated
- 2010-08-23
- Last updated
- 2010-08-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.