SOUTHERN HOME CARE (NPI# 1063746204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063746204 |
| Entity Type | Organization |
| Organization Name | SOUTHERN HOME CARE |
| Practice Address |
701 S 3rd St Cordele GA 31015-1720 |
| Mailing Address |
9901 Linn Station Rd Louisville KY 40223-3808 |
| Practice Telephone | 2292422797 |
| Mailing Telephone | 8008660860 |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2009-09-21 |
| Authorized Official Name | DEENA OMBRES (PRIVACY OFFICER) |
| Authorized Official Telephone | 5023942387 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000552538BI | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033646658 | Southern Home Care | Respite Care | 7530 Lexus Ln, Memphis, TN 38119-9006 | 2017-05-12 |
| 1538337522 | Southern Home Care | Home Health | 1399 Big A Rd, Toccoa, GA 30577-6030 | 2008-02-13 |
| 1477721454 | Southern Home Care | Home Health | 990 Holcomb Bridge Rd, Suite 2, Roswell, GA 30076-6203 | 2008-02-13 |
| 1548438534 | Southern Home Care | Home Health | 1301 Whispering Pines Rd, Albany, GA 31707-3553 | 2008-02-13 |
| 1831115781 | Southern Home Care | Pharmacy | 8865 First Industrial Dr, Southaven, MS 38671-1919 | 2006-07-14 |
| 1669703997 | Southern Home Care | Respite Care | 1921 Oxford St, Missoula, MT 59801-6640 | 2010-01-27 |
| 1467620443 | Southern Home Care | Home Health | 107 Dogwood Dr, Waynesboro, GA 30830-5448 | 2008-02-13 |
| 1457529448 | Southern Home Care | Home Health | 1551 Jennings Mill Rd, Suite 2700a, Watkinsville, GA 30677-7244 | 2008-02-13 |
| 1467620450 | Southern Home Care | Home Health | 1700 E Park Ave, Valdosta, GA 31602-3400 | 2008-02-13 |
| 1578731550 | Southern Home Care | Home Health | 105 Preston Ct, Suite B, Macon, GA 31210-5769 | 2008-02-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | SOUTHERN HOME CARE SERVICES INC. | 805 N Whittington Pkwy, Louisville, Kentucky 40222 |
| Ohio Business Entities | SOUTHERN HOME CARE SERVICES, INC | 9901 Linn Station Road, Louisville, KY 40223 |
| Oregon Corporations, Companies and Business Names | SOUTHERN HOME CARE SERVICES, INC. | 805 N Whittington Parkway Suite 400, Louisville, KY 40222 |
| Iowa Business Entities | SOUTHERN HOME CARE SERVICES, INC. | 9901 Linn Station Rd, Louisville, KY 40223 |
| Connecticut Business Registrations | SOUTHERN HOME CARE SERVICES, INC. | 9901 Linn Station Road, Louisville, KY 40223 |
| Washington State Corporations | SOUTHERN HOME CARE SERVICES, INC. | 9901 Linn Station Rd, Louisville, KY 40223 |
| Street Address |
701 S 3RD ST |
| City | CORDELE |
| State | GA |
| Zip Code | 31015-1720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618164 | Jeffrey Allen Wessel Jr. | Physical Therapist | 1107b Greer Street, Cordele, GA 31015 | 2020-08-03 |
| 1316502024 | Clifton Anthony Jordan | Specialist | 1106 East Ave Suite J, Cordele, GA 31015 | 2019-05-08 |
| 1336678440 | Robert Kenneth Lancaster | Dentist | 604 E 15th Avenue, Cordele, GA 31015 | 2017-06-12 |
| 1457602435 | Marvin Tolbert Mcafee IIi | Physician Assistant | 416 East 4th Ave, Suite B, Cordele, GA 31015 | 2012-10-01 |
| 1568719169 | Kimberly Bertelson | Physical Therapy Assistant | 1107 Greer Street, Suite B, Cordele, GA 31015 | 2012-08-14 |
| 1134474174 | R W Leitner Od LLC | Optometrist | 716-c 16th Ave East, Cordele, GA 31015 | 2012-07-16 |
| 1790048023 | Holly K Davis | Nurse Practitioner | 602 E 16th Ave Ste B, Cordele, GA 31015 | 2012-06-21 |
| 1508141482 | Beatrice Hurt Mckee | Nurse Practitioner | 216 Hospital Drive., Cordele, GA 31015 | 2011-10-11 |
| 1669784393 | Elisabeth R Waldrip | Dentist | 115 E 14th Avenue, Cordele, GA 31015 | 2010-07-10 |
| 1063656403 | Priscilla George Thomas | Surgery | 416 E 4th Ave # A, Cordele, GA 31015 | 2009-04-29 |
| Find all providers in zip 31015 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326586744 | Hand-n-hand PCh Inc. | Intermediate Care Facility, Mentally Retarded | 125 Janette Ln, Moultrie, GA 31788-7837 | 2017-02-06 |
| 1902232598 | Enable of Georgia, Inc. | Intermediate Care Facility, Mentally Retarded | 1200 Old Ellis Rd, Roswell, GA 30076-3850 | 2013-09-16 |
| 1326392432 | Extending Community Services Foundation | Intermediate Care Facility, Mentally Retarded | 3630 Emerald Pt, Decatur, GA 30034-5739 | 2012-10-29 |
| 1639441421 | Smith Personal Care Home 1and 2 Inc | Intermediate Care Facility, Mentally Retarded | 309 Advance St, Swainsboro, GA 30401-3675 | 2012-02-08 |
| 1609146109 | Rainbow Ridge#2,inc. | Intermediate Care Facility, Mentally Retarded | 181 Rainbow Rdg, Swainsboro, GA 30401-4413 | 2011-12-31 |
| 1427336346 | Tranquility PCh, LLC | Intermediate Care Facility, Mentally Retarded | 3440 Rainbow Dr, Decatur, GA 30034-1807 | 2011-07-26 |
| 1225358856 | 'a' Helping Hand, Inc. | Intermediate Care Facility, Mentally Retarded | 439 Watson Bay, Stone Mountain, GA 30087-6195 | 2010-06-05 |
| 1427378058 | Precious Living Incorporated | Intermediate Care Facility, Mentally Retarded | 448 Registry Blf, Stone Mountain, GA 30087-6602 | 2010-06-05 |
| 1720318843 | Allgood Manor Assistant Home Inc. | Intermediate Care Facility, Mentally Retarded | 6358 Deshong Dr, Lithonia, GA 30058-6123 | 2010-01-12 |
| 1275863383 | Bryana Personal Care Home | Intermediate Care Facility, Mentally Retarded | 6276 Field Glen Rd, Stone Mountain, GA 30087-4911 | 2010-01-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHERN HOME CARE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.