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Organization
SOUTHERLY HOME HEALTH LLC
Active
Organization
SOUTHERLY HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH HOLIFIELD (OWNER/CEO)
(904) 999-9243
Entity
Organization
Contact information
Practice address
1279 KINGSLEY AVE STE 114, ORANGE PARK, FL 32073-4604
(904) 999-9243
Mailing address
1279 KINGSLEY AVE STE 114, ORANGE PARK, FL 32073-4604
(904) 999-9243
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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