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General NPI Number Information
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NPI Number | 1790690162
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Entity Type | Organization
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Legal Business Name | SOUTHERN HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 127B S RICHVIEW RD
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City | CLARKSVILLE
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State | TN
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Zip | 37043-5220
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Country | US
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Telephone | 931-645-5532
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Fax | 931-645-5471
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40222-7102
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Country | US
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Telephone | 502-394-2100
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANGIE MATTINGLY
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Credential |
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Telephone | 502-394-2100
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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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Taxonomy #2
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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 |
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Taxonomy #3
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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 |
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