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General NPI Number Information
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NPI Number | 1669703997
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Entity Type | Organization
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Legal Business Name | SOUTHERN HOME CARE
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 1921 OXFORD ST
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City | MISSOULA
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State | MT
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Zip | 59801-6640
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Country | US
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Telephone | 907-770-9005
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Fax | 907-770-7980
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Provider Business Mailing Address
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Address Line | 9901 LINN STATION RD
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City | LOUISVILLE
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State | KY
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Zip | 40223-3808
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Country | US
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Telephone | 800-866-0860
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Fax |
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Authorized Official
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Title or Position | PRIVACY OFFICER
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Name | DEENA OMBRES
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Credential |
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Telephone | 502-394-2387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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