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Organization

SOUTHERNCARE, INC.

Active
Other names
Gentiva II
Organization subpart
No

Provider details

NPI number
Authorized official
JANET COMBS (VP OF LICENSURE)
(704) 662-1761
Entity
Organization

Contact information

Practice address
1911 WEST CENTER AVENUE, SUITE 1, PORTAGE, MI 49024-5367
(269) 342-9308
(269) 342-9462
Mailing address
655 BRAWLEY SCHOOL RD, SUITE 200, MOORESVILLE, NC 28117-9125
(704) 664-2876
(704) 664-1306

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
1041000077
MI
251G00000X
Community Based Hospice Care Agency
393525
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15/4610877
MI
05
4610877
MI
Enumeration date
06/04/2006
Last updated
04/07/2026
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