BROADWAY MANOR LIMITED LIABILITY NPI 1740668755

NPI Information

  • NPI: 1740668755
  • Provider Name: BROADWAY MANOR LIMITED LIABILITY
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Other Name: BROADWAY MANOR RESIDENTIAL CAREHOME
  • Address: 446 N BROADWAY STREET
    GREENVILLE, MS
    ZIP 38701
  • Phone: (662) 702-5007

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NPI Details

BROADWAY MANOR LIMITED LIABILITY is an assisted living facility in Greenville, MS. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. BROADWAY MANOR LIMITED LIABILITY NPI is 1740668755. The provider is registered as an organization entity type.
The provider Other Name Is Broadway Manor Residential Carehome.

The provider's business location address is:

446 N BROADWAY STREET
GREENVILLE, MS
ZIP 38701-552
Phone: (662) 702-5007

The provider's authorized official is Jmelba H Thompson .
The authorized official title is Director and has the following contact phone number (662) 702-5007.

The enumeration date for this NPI number is 5/11/2015 and was last updated on 7/24/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility1096MISSISSIPPIYes

What is NPI?

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This page was last updated on: 11/21/2025

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