Provider Demographics
NPI:1053664227
Name:SOUTHERLAND CONSULTING GROUP SERVICES, INC
Entity Type:Organization
Organization Name:SOUTHERLAND CONSULTING GROUP SERVICES, INC
Other - Org Name:UNITED ALLIANCE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:SOUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-978-9118
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-0417
Mailing Address - Country:US
Mailing Address - Phone:910-978-9118
Mailing Address - Fax:910-641-0001
Practice Address - Street 1:111 W ELWOOD AVE
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-2801
Practice Address - Country:US
Practice Address - Phone:910-978-9118
Practice Address - Fax:910-641-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies