Provider Demographics
NPI:1063048650
Name:EPPSINSTITUTEFORHEALTHYFAMILYANDCOMMUNITYLIVING,LLC
Entity type:Organization
Organization Name:EPPSINSTITUTEFORHEALTHYFAMILYANDCOMMUNITYLIVING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MACARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:601-918-4350
Mailing Address - Street 1:615 PINE LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3537
Mailing Address - Country:US
Mailing Address - Phone:601-918-4350
Mailing Address - Fax:
Practice Address - Street 1:501 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:TOUGALOO
Practice Address - State:MS
Practice Address - Zip Code:39174-9606
Practice Address - Country:US
Practice Address - Phone:601-918-4350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty