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NINE PALMS 2 LLC NPI 1104871094


NPI Information

NPI: 1104871094
Provider Name: NINE PALMS 2 LLC

Doing Business As: TENDER LOVING CARE, AN AMEDISYS COMPANY

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 25D1001141

Address:
11010 HIGHWAY 49
STE 4
GULFPORT, MS
ZIP 39503
Phone: (228) 831-9821
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NINE PALMS 2 LLC is a home health in Gulfport, MS. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. NINE PALMS 2 LLC NPI is 1104871094. The provider is registered as an organization entity type.
The provider Is Doing Business As Tender Loving Care, An Amedisys Company.

The provider's business location address is:

11010 HIGHWAY 49
STE 4
GULFPORT, MS
ZIP 39503-190
Phone: (228) 831-9821
Fax: (228) 831-9826

The provider's authorized official is Paul Kusserow .
The authorized official title is President and has the following contact phone number (225) 292-2031.

The CLIA number assigned to this NPI record is 25D1001141 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 9/6/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome Health12384MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000070507OTHERMISSISSIPPIBC BS OF MS
2=========OTHERMISSISSIPPISTATE FARM
3=========OTHERMISSISSIPPIINFUSION PARTNERS
4=========OTHERMISSISSIPPISELECT ADMINISTRATION SER
5=========OTHERMISSISSIPPIVITAL CARE
6=========OTHERMISSISSIPPIMS PHYSICIANS CARE NETWK
7257143MEDICARE OSCAR/CERTIFICATIONMISSISSIPPI
8=========OTHERMISSISSIPPICIGNA
9000070508OTHERMISSISSIPPIBC BS OF MS
10000070508OTHERMISSISSIPPIBC BS OF MS FED
11000070508OTHERMISSISSIPPIADVANCED HEALTH SYSTEMS
12000070507OTHERMISSISSIPPIADVANCED HEALTH SYSTEMS
13=========OTHERMISSISSIPPIVAMC
14=========OTHERMISSISSIPPIUNITED HEALTHCARE
1500770616MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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