Provider Demographics
NPI:1740238930
Name:CARE GIVERS, LLC
Entity Type:Organization
Organization Name:CARE GIVERS, LLC
Other - Org Name:CLARKSDALE NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-709-1408
Mailing Address - Street 1:1120 RITCHIE AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-7535
Mailing Address - Country:US
Mailing Address - Phone:662-627-2591
Mailing Address - Fax:662-624-6233
Practice Address - Street 1:1120 RITCHIE AVE
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-7535
Practice Address - Country:US
Practice Address - Phone:662-627-2591
Practice Address - Fax:662-624-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS482314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0023099Medicaid
MS80340OtherBLUE CROSS BLUE SHIELD
MS0023099Medicaid