Provider Demographics
NPI:1063677359
Name:SOUTHERN CARE PROVIDERS, INC
Entity Type:Organization
Organization Name:SOUTHERN CARE PROVIDERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-774-9200
Mailing Address - Street 1:1515 HARDING BLVD
Mailing Address - Street 2:STE. A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-5461
Mailing Address - Country:US
Mailing Address - Phone:225-774-9200
Mailing Address - Fax:
Practice Address - Street 1:1515 HARDING BLVD
Practice Address - Street 2:STE. A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-5461
Practice Address - Country:US
Practice Address - Phone:225-774-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health