Organization
SOUTHERN LIVING HOME CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZANY GRAY (ADMINISTRATOR)
(336) 710-1833
Entity
Organization
Contact information
Practice address
177 WINDGATE CT, MOUNT AIRY, NC 27030-7821
(336) 710-1833
Mailing address
1203 W LEBANON ST, MOUNT AIRY, NC 27030-2244
(336) 710-1833
(336) 374-2803
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4188
NC
385H00000X
Respite Care
HC4188
NC
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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