Southern Health Care Corporation

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

228561 Issued in FL

Legal business name

SOUTHERN HEALTH CARE CORPORATION

Practice address

633 NE 167TH St
Suite 602
North Miami Beach, FL 33162-2442

Phone

(305) 249-0660

Fax

(305) 249-0650

NPI assigned

Jul 28, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Joshua S Ajayi

Title

President

Phone

(305) 249-0660

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• SOUTHERN HOMEMAKER AND COMPANION SERVICES Doing business as

Locations

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1124259965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 NE 167TH ST",
            "address_2": "SUITE 602",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331622442",
            "telephone_number": "305-249-0660",
            "fax_number": "305-249-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 NE 167TH ST",
            "address_2": "SUITE 602",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331622442",
            "telephone_number": "305-249-0660",
            "fax_number": "305-249-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-249-0660",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "228561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DEVELOPMENTAL DISABILITY WAIVER",
            "identifier": "682363796",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AGED AND DISABLED ADULT WAIVER",
            "identifier": "683012900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FAMILIAL DYSAUTONOMIA WAIVER",
            "identifier": "682363703",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FSL WAIVER",
            "identifier": "682363798",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROJECT AIDS CARE WAIVER",
            "identifier": "682028000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN HOMEMAKER AND COMPANION SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.