# SOUTHERN COMFORT PCA

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

## Provider details

- **NPI number:** 1982060349
- **Authorized official:** SHAMEIKA AMIN (ADMINSTRATOR)
- **Authorized official phone:** (702) 868-2905

## Contact information

- **Practice address:** 3925 W CHEYENNE AVE STE 401, N LAS VEGAS, NV 89032-3495
- **Practice address phone:** (702) 868-8905
- **Mailing address:** 3925 W CHEYENNE AVE STE 401, N LAS VEGAS, NV 89032-3495
- **Mailing address phone:** (702) 868-8905

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 8389PCS | NV | Yes |

## Other

- **Enumeration date:** 01/14/2016
- **Last updated:** 01/14/2016