SOUTH COUNTY HOME HEALTH PROVIDERS (NPI# 1477853422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477853422 |
| Entity Type | Organization |
| Organization Name | SOUTH COUNTY HOME HEALTH PROVIDERS |
| Practice Address |
115 N 3rd St Vicksburg MI 49097-1017 |
| Practice Telephone | 2695323127 |
| Practice Fax Number | 2696494796 |
| Mailing Telephone | 2695323127 |
| Mailing Fax Number | 2696494796 |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2011-07-01 |
| Authorized Official Name | MS. TINA MARIE GRIFFITH (PRESIDENT/ C.E.O.) |
| Authorized Official Telephone | 2695323127 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | AF390303489 | MI | Residential Treatment Facilities |
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | AF390303489 | MI | Residential Treatment Facilities |
| Street Address |
115 N 3RD ST |
| City | VICKSBURG |
| State | MI |
| Zip Code | 49097-1017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912132168 | Jo Lynne Kirchhoff | Pharmacist | 110 S. Main Streets, Vicksburg, MI 49097 | 2009-05-18 |
| 1558429605 | Ellen Marie Tavarone | Dentist | 602 West Prairie St, Vicksburg, MI 49097 | 2006-12-04 |
| 1598875601 | Robert L Dornbos Dds PC | Dentist | 102 S Main, Vicksburg, MI 49097 | 2006-08-30 |
| 1982680468 | Freds Super Pharmacy Inc | Pharmacy | 121 W Prairie St, Vicksburg, MI 49097 | 2005-12-16 |
| 1023214921 | Aaron C Ford | Dentist | 602 W Prairie St, Vicksburg, MI 49097-1178 | 2007-06-26 |
| 1154573392 | Family & Children Services, Inc. | Clinic/Center | 101 S Main St, Vicksburg, MI 49097-1210 | 2008-10-21 |
| 1144756610 | Pamela Hendershot | Pharmacist | 110 S Main St, Vicksburg, MI 49097-1211 | 2017-05-03 |
| 1598990525 | Kelly Ann Soekarmoen | Pharmacist | 110 S Main St, Vicksburg, MI 49097-1211 | 2009-05-19 |
| 1184670085 | Hill's Pharmacy of Vicksburg, Inc. | Pharmacy | 110 S Main St, Vicksburg, MI 49097-1211 | 2006-05-25 |
| 1982684916 | Robert L Dornbos | Dentist | 102 S Main St, Vicksburg, MI 49097-1211 | 2006-01-17 |
| Find all providers in zip 49097 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083173017 | Newport Care Center | Residential Treatment Facility, Physical Disabilities | 22977 Newport St, Southfield, MI 48075-5850 | 2019-03-19 |
| 1104352285 | Tukeisha Snedecar | Residential Treatment Facility, Physical Disabilities | 19210 Conley St, Detroit, MI 48234-2276 | 2017-05-10 |
| 1760925556 | Connect Care Network Inc. | Residential Treatment Facility, Physical Disabilities | 19761 Annott St, Detroit, MI 48205-1603 | 2016-11-28 |
| 1750832564 | First Door, LLC | Residential Treatment Facility, Physical Disabilities | 25584 W 10 Mile Rd, Southfield, MI 48033-4826 | 2016-10-17 |
| 1306390737 | Nikeyla Blakeney | Residential Treatment Facility, Physical Disabilities | 15384 Freeland St, Detroit, MI 48227-2911 | 2016-08-15 |
| 1558815068 | Charlie Hudson | Residential Treatment Facility, Physical Disabilities | 15831 Woodworth, Redford, MI 48239-3970 | 2016-08-12 |
| 1801249222 | Cm Org | Residential Treatment Facility, Physical Disabilities | 7621 Parkland, Detroit, MI 48239-1031 | 2016-07-20 |
| 1548635618 | Milad Jabow | Residential Treatment Facility, Physical Disabilities | 5126 Allison Dr, Troy, MI 48085-3468 | 2015-12-01 |
| 1831568500 | Expert Enterprises | Residential Treatment Facility, Physical Disabilities | 18453 Woodingham Dr Uppr, Detroit, MI 48221-2155 | 2015-09-23 |
| 1396113767 | Ltss Inc | Residential Treatment Facility, Physical Disabilities | 3801 S 39 Rd, Cadillac, MI 49601-9126 | 2015-09-02 |
| Find all providers with the same taxonomy | ||||
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| 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.