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NPI 1992865653 · Attendant Care Provider · Ellisville, MS
Provider details
- NPI number
- 1992865653
- Entity type
- Organization
- Primary specialty
- Attendant Care ProviderNursing Service Related Providers
- Organization subpart
- No
- Authorized official
- Suzie Lassiter, Director of Facility(601) 477-9384
- License
- ESS-BMR (MS)
Specialties & taxonomies
Nursing Service Related Providers
Practice location
1101 Highway 11 S
Ellisville, MS 39437-4443
Phone: (601) 477-9384
Fax: (601) 477-5700
Approximate (ZIP-level) locationGet directions
Mailing address
1101 Highway 11 S
Ellisville, MS 39437-4443
Registry dates
- Enumerated
- 2006-12-11
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.