# SOUTHERN COMFORT HEALTH CARE SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144966581
- **Authorized official:** MR. TIMOTHY MOANA WILSON JR. BA, MBA (CEO)
- **Authorized official phone:** (570) 688-8490

## Contact information

- **Practice address:** 2100 N HWY 360 STE 1201, GRAND PRAIRIE, TX 75050-8708
- **Practice address phone:** (570) 688-8490
- **Practice address fax:** (214) 593-5615
- **Mailing address:** 2100 N HWY 360 STE 1201, GRAND PRAIRIE, TX 75050-8708
- **Mailing address phone:** (570) 688-8490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 372600000X | Adult Companion | — | NULL | — |
| 372600000X | Adult Companion | — | — | — |
| 3747P1801X | Personal Care Attendant | — | NULL | — |
| 3747P1801X | Personal Care Attendant | — | — | — |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |

## Other

- **Enumeration date:** 05/09/2022
- **Last updated:** 01/29/2026