Organization
SOUTHERN HOME CARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (PROVIDER ENROLLMENT MANAGER)
(502) 630-7425
Entity
Organization
Contact information
Practice address
138 CANAL ST STE 407, POOLER, GA 31322-4048
(912) 748-5116
Mailing address
138 CANAL ST STE 407, POOLER, GA 31322-4048
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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