Organization Name: | SOUTHERN COMFORT PCA |
NPI Number: | 1245696608 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHAMEIKA AMIN (ADMINSTRATOR) |
Mailing Address: | 3925 W Cheyenne Ave Ste 401 North Las Vegas |
State: | NV US |
Postal Code: | 890323495 |
Phone Number: | 7088682905 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2016 |
NPI Last Update Date: | 01/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 8389PCS |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |