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General NPI Number Information
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NPI Number | 1336043918
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Entity Type | Organization
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Legal Business Name | SOUTHERN SUPPORTS AGENCY, INC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 13 SW 14TH AVE
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City | CAPE CORAL
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State | FL
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Zip | 33991-1411
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Country | US
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Telephone | 954-288-8449
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Fax |
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Provider Business Mailing Address
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Address Line | 13 SW 14TH AVE
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City | CAPE CORAL
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State | FL
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Zip | 33991-1411
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Country | US
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Telephone | 954-288-8449
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | TONI R MOSLEY-HALL
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Credential |
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Telephone | 954-288-8449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State | NULL
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Taxonomy #6
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | NULL
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Taxonomy #7
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | NULL
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Taxonomy #8
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | NULL
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Taxonomy #9
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State | NULL
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Taxonomy #10
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | NULL
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Taxonomy #11
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NULL
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