# SOUTHERN HOME CARE SERVICES, INC.

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

## Provider details

- **NPI number:** 1770410151
- **Authorized official:** ANGIE MATTINGLY (DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (502) 394-2100

## Contact information

- **Practice address:** 1180 E MCNEESE ST STE A, LAKE CHARLES, LA 70607-4754
- **Practice address phone:** (337) 458-1045
- **Mailing address:** 805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101

## Taxonomy

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