Provider Demographics
NPI:1639341506
Name:SOUTHLAND HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:SOUTHLAND HEALTHCARE SERVICES, INC.
Other - Org Name:BELTONE HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RURI
Authorized Official - Last Name:UMLAUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-577-2360
Mailing Address - Street 1:7421 DOUGLAS BLVD
Mailing Address - Street 2:STE F
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1564
Mailing Address - Country:US
Mailing Address - Phone:770-577-2360
Mailing Address - Fax:770-577-2364
Practice Address - Street 1:7421 DOUGLAS BLVD
Practice Address - Street 2:STE F
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1564
Practice Address - Country:US
Practice Address - Phone:770-577-2360
Practice Address - Fax:770-577-2364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty