Organization
SOUTHERNCARE, INC.
Active
Other names
Gentiva
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JANET COMBS (VP OF LICENSURE)
(704) 662-1761
Entity
Organization
Contact information
Practice address
590 BOARDWALK BLVD, SUITE BO-590, BOSSIER CITY, LA 71111-4384
(318) 227-9160
(318) 227-9781
Mailing address
PO BOX 4060, MOORESVILLE, NC 28117-4060
(704) 662-0416
(704) 664-1306
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
131
LA
251G00000X
Community Based Hospice Care Agency
Primary
257
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1580881
—
LA
Enumeration date
06/04/2006
Last updated
01/11/2023
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