Provider Demographics
NPI:1275384083
Name:MAJASTY LIVING
Entity Type:Organization
Organization Name:MAJASTY LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAKEBA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITE CHANAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-572-7207
Mailing Address - Street 1:1368 OLD FANNIN RD STE 250
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-8025
Mailing Address - Country:US
Mailing Address - Phone:769-572-7207
Mailing Address - Fax:601-510-4844
Practice Address - Street 1:1368 OLD FANNIN RD STE 250
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-8025
Practice Address - Country:US
Practice Address - Phone:769-572-7207
Practice Address - Fax:601-510-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances