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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 MATTINGLY (DIRECTOR PROVIDER ENROLLMENT)
(502) 394-2100
Entity
Organization
Contact information
Practice address
1180 E MCNEESE ST STE A, LAKE CHARLES, LA 70607-4754
(337) 458-1045
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
NULL
372500000X
Chore Provider
—
NULL
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
NULL
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
NULL
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
NULL
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
05/07/2026
Last updated
05/19/2026
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