Organization Name: | SOUTHERNCARE, INC. |
NPI Number: | 1386682755 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JESSICA KLEBERG (VP OF LEGAL AFFAIRS) |
Mailing Address: | 935 Mezzanine Dr Lafayette |
State: | IN US |
Postal Code: | 479058645 |
Phone Number: | 7654484732 |
Fax Number: | 7654484741 |
NPI Enumeration Date: | 06/04/2006 |
NPI Last Update Date: | 05/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 040039001 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |