Organization
SOUTHERN PROFESSIONAL HOME CARE LLC
Active
Other names
Southern Professional Home Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN ELAINE JACKSON MA, BSW (ADMINISTRATOR/CEO)
(864) 419-0167
Entity
Organization
Contact information
Practice address
1200 WOODRUFF RD STE A3, GREENVILLE, SC 29607-5732
(864) 419-0167
(864) 213-6317
Mailing address
1200 WOODRUFF RD STE A3, GREENVILLE, SC 29607-5732
(864) 419-0167
(864) 213-6317
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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