Healthcare Provider Details

I. General information

NPI: 1326965211
Provider Name (Legal Business Name): SOUTHERN LIVING HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 E 13TH CT
PANAMA CITY FL
32401-5081
US

IV. Provider business mailing address

3125 E 13TH CT
PANAMA CITY FL
32401-5081
US

V. Phone/Fax

Practice location:
  • Phone: 850-481-9408
  • Fax:
Mailing address:
  • Phone: 850-481-9408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMECCO MORGAN MORGAN
Title or Position: CEO
Credential:
Phone: 850-481-9408