Healthcare Provider Details

I. General information

NPI: 1073443602
Provider Name (Legal Business Name): SOUTHERN LIFE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11843 BRICKSOME AVE STE B
BATON ROUGE LA
70816-5310
US

IV. Provider business mailing address

9618 JEFFERSON HWY # 194
BATON ROUGE LA
70809-9636
US

V. Phone/Fax

Practice location:
  • Phone: 225-280-9626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: RASHEDA MOSBY
Title or Position: SPEECH PATHOLOGIST/OWNER
Credential: M.S.,CCC-SLP
Phone: 225-280-9625