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General NPI Number Information
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NPI Number | 1336338763
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Entity Type | Organization
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Legal Business Name | SOUTHERN HEALTHCARE AGENCY, INC.
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 301 NEW POINTE
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City | RIDGELAND
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State | MS
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Zip | 39157-3904
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Country | US
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Telephone | 601-933-0037
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Fax | 601-932-8468
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Provider Business Mailing Address
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Address Line | 301 NEW POINTE
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City | RIDGELAND
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State | MS
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Zip | 39157-3904
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Country | US
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Telephone | 601-933-0037
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Fax | 601-932-8468
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Authorized Official
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Title or Position | CEO
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Name | MS. JACKIE D. MCMILLAN
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Credential |
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Telephone | 601-933-0037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 27 17 009C
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License Number State | MS
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