Organization
SOUTHERN HOME PRIVATE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY M MOORE (OWNER)
(601) 686-1589
Entity
Organization
Contact information
Practice address
906 20TH AVE, STE 115, MERIDIAN, MS 39301-5153
(601) 686-1589
Mailing address
906 20TH AVE, STE 115, MERIDIAN, MS 39301-5153
(601) 686-1589
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/02/2015
Last updated
12/06/2016
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