Healthcare Provider Details
I. General information
NPI: 1649508375
Provider Name (Legal Business Name): SOUTHERN HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2009
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
909 SUMNEYTOWN PIKE SUITE 105
SPRING HOUSE PA
19477-1011
US
IV. Provider business mailing address
9901 LINN STATION RD
LOUISVILLE KY
40223-3808
US
V. Phone/Fax
- Phone: 800-866-0860
- Fax:
- Phone: 800-866-0860
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
DEENA
OMBRES
Title or Position: PRIVACY OFFICER
Credential:
Phone: 502-394-2387