Provider Demographics
NPI:1598275828
Name:ROOTS HEALTHCARE AND HOMES, LLC
Entity Type:Organization
Organization Name:ROOTS HEALTHCARE AND HOMES, LLC
Other - Org Name:ROOTS HEALTHCARE AND HOMES; HEROES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:760-270-3791
Mailing Address - Street 1:292 PICKENS CIR
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-7982
Mailing Address - Country:US
Mailing Address - Phone:760-270-3791
Mailing Address - Fax:
Practice Address - Street 1:292 PICKENS CIRCLE
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051
Practice Address - Country:US
Practice Address - Phone:760-270-3791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No305S00000XManaged Care OrganizationsPoint of Service
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care