Provider Demographics
NPI:1780790022
Name:SOUTHERN HOME CARE SERVICES
Entity type:Organization
Organization Name:SOUTHERN HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CURLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-242-2797
Mailing Address - Street 1:1700 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-3400
Mailing Address - Country:US
Mailing Address - Phone:229-242-2797
Mailing Address - Fax:229-242-2797
Practice Address - Street 1:1700 E PARK AVE
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-3400
Practice Address - Country:US
Practice Address - Phone:229-242-2797
Practice Address - Fax:229-242-2797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060R0070251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID NUMBER