Provider Demographics
NPI:1003842345
Name:SOUTHERN HOME THERAPY LLC
Entity Type:Organization
Organization Name:SOUTHERN HOME THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALECHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-283-4381
Mailing Address - Street 1:780 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3211
Mailing Address - Country:US
Mailing Address - Phone:205-620-6775
Mailing Address - Fax:866-927-6884
Practice Address - Street 1:780 2ND ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-3211
Practice Address - Country:US
Practice Address - Phone:205-620-6775
Practice Address - Fax:866-927-6884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies