Organization
SOUTHERNCARE, INC.
Active
Other names
Southern Care Bloomington
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KLEBERG (VP OF LEGAL AFFAIRS)
(704) 664-2876
Entity
Organization
Contact information
Practice address
1923 S LIBERTY DR, BLOOMINGTON, IN 47403-5146
(812) 334-8343
(812) 334-8949
Mailing address
655 BRAWLEY SCHOOL RD, SUITE 200, MOORESVILLE, NC 28117-9125
(704) 664-2876
(704) 662-1306
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
14-002998-1
IN
251G00000X
Community Based Hospice Care Agency
SATELLITE OFFICE
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200424080B
—
IN
Enumeration date
06/07/2006
Last updated
05/16/2016
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