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Organization
SOUTHERN HOME CARE SERVICES, INC.
Active
Organization
SOUTHERN HOME CARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTTINGLY (DIRECTOR PROVIDER ENROLLMENT)
(502) 394-2100
Entity
Organization
Contact information
Practice address
2296 HENDERSON MILL RD NE, SUITE 202, ATLANTA, GA 30345-2739
(770) 414-1350
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-5186
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000552538N
—
GA
Enumeration date
02/13/2008
Last updated
07/31/2026
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