Provider Demographics
NPI:1164797361
Name:SOUTHLAND HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:SOUTHLAND HEALTHCARE SERVICES, INC
Other - Org Name:SOUTHLAND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-974-2075
Mailing Address - Street 1:8200 WEDNESBURY LANE
Mailing Address - Street 2:#410
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:281-974-2075
Mailing Address - Fax:832-767-1965
Practice Address - Street 1:8200 WEDNESBURY LANE
Practice Address - Street 2:#410
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:281-974-2075
Practice Address - Fax:832-767-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX015080251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based