Provider Demographics
NPI:1326829219
Name:SOUTHERN STAR PLACEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:SOUTHERN STAR PLACEMENT SERVICES, LLC
Other - Org Name:SKS HOME CARE, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-335-6810
Mailing Address - Street 1:620 MONTE CARLO DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4416
Mailing Address - Country:US
Mailing Address - Phone:615-335-6810
Mailing Address - Fax:
Practice Address - Street 1:504 ENON SPRINGS RD E
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4409
Practice Address - Country:US
Practice Address - Phone:615-335-6810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health