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
1990 S FRONTAGE RD STE I, VICKSBURG, MS 39180-5232
(601) 924-8285
(601) 924-8788
Mailing address
P O BOX 4060, ATTN: REGULATORY, MOORESVILLE, NC 28117-4060
(704) 664-2876
(704) 664-1306
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
061
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770385
—
MS
Enumeration date
06/03/2006
Last updated
01/17/2023
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