Provider Demographics
NPI:1164845210
Name:R S ENTERPRISE
Entity Type:Organization
Organization Name:R S ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:SILAS
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:601-960-7426
Mailing Address - Street 1:532 BURNS ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39203-3601
Mailing Address - Country:US
Mailing Address - Phone:601-960-7426
Mailing Address - Fax:601-960-7426
Practice Address - Street 1:532 BURNS ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39203-3601
Practice Address - Country:US
Practice Address - Phone:601-960-7426
Practice Address - Fax:601-960-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-26
Last Update Date:2014-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS311ZA0620X311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home