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Organization

SOUTHERNCARE, INC.

Active
Other names
SouthernCare South Bend
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER TYLER (VP OF REGULATORY COUNSEL)
(678) 449-0459
Entity
Organization

Contact information

Practice address
1626 E DAY RD, MISHAWAKA, IN 46545-3469
(574) 259-0895
(574) 259-0899
Mailing address
PO BOX 4060, MOORESVILLE, NC 28117-4060
(704) 664-2876
(704) 664-1306

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
050037231
IN
251G00000X
Community Based Hospice Care Agency
Primary
14-003723-1
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200451230A
IN
Enumeration date
06/02/2006
Last updated
05/07/2026
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