Provider Demographics
NPI:1518392604
Name:SOUTHERN HOSPITALITY CARE SERVICES LLC
Entity type:Organization
Organization Name:SOUTHERN HOSPITALITY CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-634-2145
Mailing Address - Street 1:3351 RS COUNTY ROAD 1605
Mailing Address - Street 2:
Mailing Address - City:LONE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75453-8006
Mailing Address - Country:US
Mailing Address - Phone:903-634-2145
Mailing Address - Fax:
Practice Address - Street 1:3351 RS COUNTY ROAD 1605
Practice Address - Street 2:
Practice Address - City:LONE OAK
Practice Address - State:TX
Practice Address - Zip Code:75453-8006
Practice Address - Country:US
Practice Address - Phone:903-634-2145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0801264146253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care