Provider Demographics
NPI:1538475157
Name:SOUTHERN COMFORTS, LLC
Entity Type:Organization
Organization Name:SOUTHERN COMFORTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-372-1303
Mailing Address - Street 1:PO BOX 695
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38503-0695
Mailing Address - Country:US
Mailing Address - Phone:931-520-0968
Mailing Address - Fax:931-520-0971
Practice Address - Street 1:118 S DIXIE AVE STE 1
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3415
Practice Address - Country:US
Practice Address - Phone:931-520-0968
Practice Address - Fax:931-520-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000006229253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care