Southeast Home Care Services Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

076-R-119 Issued in GA

Legal business name

SOUTHEAST HOME CARE SERVICES INC

Practice address

312 N Davis Dr
Warner Robins, GA 31093-3350

Phone

(478) 951-7769

Fax

(855) 898-0022

NPI assigned

Jan 30, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jennifer R Spence, R.N.

Title

Owner

Phone

(478) 297-4755

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1043757099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 N DAVIS DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933350",
            "telephone_number": "478-951-7769",
            "fax_number": "855-898-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N DAVIS DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933350",
            "telephone_number": "478-951-7769",
            "fax_number": "855-898-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST HOME CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-297-4755",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "076-R-119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HOME CARE PROVIDER LICENSE/HFR/DCH",
            "identifier": "076-R-1119",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.