Provider Demographics
NPI:1053576645
Name:SOUTHERN CARE, INC.
Entity type:Organization
Organization Name:SOUTHERN CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-535-0250
Mailing Address - Street 1:1687 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2307
Mailing Address - Country:US
Mailing Address - Phone:803-535-0250
Mailing Address - Fax:803-535-0950
Practice Address - Street 1:1687 LONGWOOD DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2307
Practice Address - Country:US
Practice Address - Phone:803-535-0250
Practice Address - Fax:803-535-0950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCRC 797310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility