Provider Demographics
NPI:1992031470
Name:FIRST SOUTHERNCARE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:FIRST SOUTHERNCARE HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT ADM/ALT DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:O
Authorized Official - Last Name:OKOJIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-205-3886
Mailing Address - Street 1:9560 SKILLMAN ST STE 122A
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-8256
Mailing Address - Country:US
Mailing Address - Phone:214-205-3886
Mailing Address - Fax:
Practice Address - Street 1:9560 SKILLMAN ST STE 122A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8256
Practice Address - Country:US
Practice Address - Phone:214-205-3886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health