# SOUTHERN HOME HEALTH AT KWCC INC

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

## Provider details

- **NPI number:** 1245379882
- **Authorized official:** MS. ROBERTA A CARON (CORPORATE BILLING DIRECTOR)
- **Authorized official phone:** (561) 333-1372

## Contact information

- **Practice address:** 5860 COLLEGE RD, KEY WEST, FL 33040-4314
- **Practice address phone:** (305) 296-2450
- **Practice address fax:** (305) 296-9197
- **Mailing address:** 5860 COLLEGE RD, KEY WEST, FL 33040-4314
- **Mailing address phone:** (305) 296-2450
- **Mailing address fax:** (305) 296-9197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | FL | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 08/22/2020