Organization
SOUTHERN COMFORT HEALTH CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY MOANA WILSON JR. BA, MBA (CEO)
(570) 688-8490
Entity
Organization
Contact information
Practice address
2100 N HWY 360 STE 1201, GRAND PRAIRIE, TX 75050-8708
(570) 688-8490
(214) 593-5615
Mailing address
2100 N HWY 360 STE 1201, GRAND PRAIRIE, TX 75050-8708
(570) 688-8490
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
05/09/2022
Last updated
01/29/2026
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