Healthcare Provider Details

I. General information

NPI: 1124264015
Provider Name (Legal Business Name): SOUTHERN HEALTH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2008
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6293C HIGHWAY 23 SOUTH
WAYNESBORO GA
30830
US

IV. Provider business mailing address

6293C HIGHWAY 23 SOUTH
WAYNESBORO GA
30830
US

V. Phone/Fax

Practice location:
  • Phone: 706-554-0241
  • Fax: 706-554-0241
Mailing address:
  • Phone: 706-554-0241
  • Fax: 706-554-0241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MARCI HARKINS
Title or Position: OWNER
Credential:
Phone: 706-554-0241