Organization Active NPI

Southwood Home Services, LLC.

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1043906175
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SOUTHWOOD HOME SERVICES, LLC.
Practice address
1354 Wells St
Philadelphia, PA 19111-4922
Phone
(484) 358-6379
NPI assigned
Apr 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Mrs. Gigi Monique Southwood-Long
Title
Ceo
Phone
(267) 901-1635

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1354 Wells St
Philadelphia, PA 19111-4922

Mailing address

4640 E Roosevelt Blvd Ste 3
Philadelphia, PA 19124-2300
Phone (267) 901-1635

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1043906175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 E ROOSEVELT BLVD STE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242300",
            "telephone_number": "267-901-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 WELLS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191114922",
            "telephone_number": "484-358-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWOOD HOME SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "SOUTHWOOD-LONG",
        "authorized_official_first_name": "GIGI",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-901-1635",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.