Provider Demographics
NPI:1518119379
Name:SOUTHERN CARE SERVICES LLC
Entity Type:Organization
Organization Name:SOUTHERN CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SERNEKA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-362-0376
Mailing Address - Street 1:905 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-2215
Mailing Address - Country:US
Mailing Address - Phone:504-362-0376
Mailing Address - Fax:504-365-0878
Practice Address - Street 1:905 MONROE ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-2215
Practice Address - Country:US
Practice Address - Phone:504-362-0376
Practice Address - Fax:504-365-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8739253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care