Organization
SOUTHERN HOSPITALITY AT HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIERRA BACON (CEO/OWNER)
(478) 295-0946
Entity
Organization
Contact information
Practice address
511 N COBB ST STE 4, MILLEDGEVILLE, GA 31061-3278
(478) 295-0946
(478) 295-0434
Mailing address
4786 HIGH OAK DR, MACON, GA 31210-5647
(912) 314-3811
(478) 259-3820
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
04/26/2023
Last updated
09/08/2024
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