Organization
SOUTHERNCARE, INC.
Active
Other names
Gentiva II
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET COMBS (VP OF LICENSURE)
(704) 664-2876
Entity
Organization
Contact information
Practice address
1119 PARK AVE STE 7, MEADVILLE, PA 16335-3107
(814) 336-4660
(814) 336-3378
Mailing address
PO BOX 4060, MOORESVILLE, NC 28117-4060
(704) 664-2876
(704) 664-1306
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
16811601
PA
251G00000X
Community Based Hospice Care Agency
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00890434000
—
PA
05
—
1008904340007
—
PA
01
—
16811601
STATE LICENSE NUMBER
PA
Enumeration date
06/23/2006
Last updated
01/17/2023
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