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General NPI Number Information
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NPI Number | 1730741604
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Entity Type | Organization
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Legal Business Name | SOUTHERN COMFORT HOME CARE INC
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 07/05/2019
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Provider Practice Location Address
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Address Line | 5630 PARK BLVD N STE C
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3355
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Country | US
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Telephone | 727-542-7423
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Fax |
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Provider Business Mailing Address
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Address Line | 908 WOODBRIDGE CT
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-2951
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Country | US
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Telephone | 727-542-7423
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE TEVLIN
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Credential |
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Telephone | 727-542-7423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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