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Organization

SOUTHERNCARE, INC.

Active
Other names
SouthernCare Lucedale
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA KLEBERG (VP OF LEGAL AFFAIRS)
(704) 664-2876
Entity
Organization

Contact information

Practice address
98 GLEN OAKS DR, LUCEDALE, MS 39452-5857
(662) 578-4072
(662) 578-7956
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
039
MS
251G00000X
Community Based Hospice Care Agency
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00770379
MS
Enumeration date
06/04/2006
Last updated
05/16/2016
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