NPIMap

Organization Active NPI

Southern Comfort Living Personal Care Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Savannah, GA
National Provider Identifier
1174137277
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
SOUTHERN COMFORT LIVING PERSONAL CARE HOME
Practice address
604 Sugarbush Cir
Savannah, GA 31406-4434
Phone
(912) 996-9261
NPI assigned
Sep 4, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Authorized official

Name
Ms. Jacqueline Dingle, B.A.NPI 1750995155
Title
Owner
Phone
(912) 996-9261

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

604 Sugarbush Cir
Savannah, GA 31406-4434

Mailing address

604 Sugarbush Cir
Savannah, GA 31406-4434
Phone (912) 996-9261

National Provider Directory

National Provider Directory
Tax ID family
Southern Comfort Living Personal Care Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1174137277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SUGARBUSH CIR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064434",
            "telephone_number": "912-996-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SUGARBUSH CIR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064434",
            "telephone_number": "912-996-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COMFORT LIVING PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "DINGLE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-996-9261",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.