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CLAIBORNE COUNTY NURSING CENTER, INC.

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Company Details

Name: CLAIBORNE COUNTY NURSING CENTER, INC.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 04 Apr 1991 (34 years ago)
Business ID: 579468
ZIP code: 39110
County: Madison
State of Incorporation: MISSISSIPPI
Principal Office Address: 125 Fountains BlvdMadison, MS 39110

Agent

Name Role Address
Kelly, Charles Bruce Agent 125 Fountains Blvd, Madison, MS 39110

Incorporator

Name Role Address
C Ralph Tillman Incorporator 300 S Commerce, Natchez, MS 39120
Charles Bruce Kelly Incorporator 10 Colony Dr, Natchez, MS 39120

Director

Name Role Address
Charles Bruce Kelly Director 125 Fountains Blvd, Madison, MS 39110

President

Name Role Address
Charles Bruce Kelly President 125 Fountains Blvd, Madison, MS 39110

Chief Executive Officer

Name Role Address
Charles Bruce Kelly Chief Executive Officer 125 Fountains Blvd, Madison, MS 39110

National Provider Identifier

NPI Number:
1225012941

Authorized Person:

Name:
MRS. TINA L ELLIS
Role:
COMPTROLLER
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
6014378724

Filings

Type Status Filed Date Description
Annual Report Filed 2025-03-24 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2024-03-15 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2023-02-13 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2022-02-01 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2021-04-21 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2020-02-12 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2019-02-07 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2018-02-05 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Annual Report Filed 2017-01-31 Annual Report For CLAIBORNE COUNTY NURSING CENTER, INC.
Registered Agent Change of Address Filed 2016-04-19 Agent Address Change For Kelly, Charles Bruce

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Date of last update: 21 Apr 2025

Sources: Mississippi Secretary of State