# SOUTHERN HOME CARE SERVICES, INC.

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

## Provider details

- **NPI number:** 1629246616
- **Authorized official:** ANGIE MATTTINGLY (DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (502) 394-2100

## Contact information

- **Practice address:** 2296 HENDERSON MILL RD NE, SUITE 202, ATLANTA, GA 30345-2739
- **Practice address phone:** (770) 414-1350
- **Mailing address:** 805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-5186

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/13/2008
- **Last updated:** 07/31/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000552538N | — | GA |