Provider Demographics
NPI:1801171434
Name:KEPLERE INSTITUTE OF TECHNOLOGY
Entity type:Organization
Organization Name:KEPLERE INSTITUTE OF TECHNOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-580-5038
Mailing Address - Street 1:560 S MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-5347
Mailing Address - Country:US
Mailing Address - Phone:662-580-5038
Mailing Address - Fax:662-580-5276
Practice Address - Street 1:560 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-5347
Practice Address - Country:US
Practice Address - Phone:662-580-5038
Practice Address - Fax:662-580-5276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03937098Medicaid
MS08139590Medicaid