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General NPI Number Information
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NPI Number | 1528003670
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Entity Type | Organization
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Legal Business Name | SOUTHERN IA HOME HEALTH CARE
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 121 BENTON AVE W
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City | ALBIA
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State | IA
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Zip | 52531-1925
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Country | US
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Telephone | 641-932-7521
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Fax | 641-932-7463
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Provider Business Mailing Address
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Address Line | PO BOX 262
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City | ALBIA
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State | IA
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Zip | 52531-0262
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Country | US
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Telephone | 641-932-7521
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Fax | 641-932-7463
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Authorized Official
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Title or Position | R.N./ADMINISTRATOR/OWNER
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Name | MRS. ANN MARIE O'BRIEN
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Credential | R.N.
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Telephone | 641-932-7521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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