Organization
SOUTHERNCARE, INC.
Active
Other names
Gentiva
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET COMBS (VP OF LICENSURE)
(704) 664-2876
Entity
Organization
Contact information
Practice address
706 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2366
(601) 990-2315
(601) 579-9495
Mailing address
PO BOX 4060, MOORESVILLE, NC 28117-4060
(704) 664-2878
(704) 664-1306
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
062
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770378
—
MS
Enumeration date
06/06/2006
Last updated
04/21/2023
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