Provider Demographics
NPI:1063725331
Name:CARRINGTON HOUSE
Entity type:Organization
Organization Name:CARRINGTON HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OENER
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:662-424-2186
Mailing Address - Street 1:1670 WHITEHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:IUKA
Mailing Address - State:MS
Mailing Address - Zip Code:38852-9013
Mailing Address - Country:US
Mailing Address - Phone:662-424-2186
Mailing Address - Fax:662-423-3398
Practice Address - Street 1:1670 WHITEHOUSE RD
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-9013
Practice Address - Country:US
Practice Address - Phone:662-424-2186
Practice Address - Fax:662-423-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05351056310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility