Southern Support Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHERN SUPPORT SERVICES, LLC

Practice address

514 2ND Loop Rd
Suite C
Florence, SC 29505-2848

Phone

(843) 665-5181

Fax

(843) 665-5189

NPI assigned

Dec 12, 2012

Last updated

Dec 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Ann Grant, MSW, LCSWA

Title

QMTD

Phone

(252) 702-9176

Specialties & licenses 1

Addresses

Tax ID family

Southern Support Services2 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.

• Southern Support Services

  • Community/Behavioral Health Agency
  • Florence, SC
  • NPI 1245512821
  NPD tax ID

Locations

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1235475609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 2ND LOOP RD",
            "address_2": "SUITE C",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295052848",
            "telephone_number": "843-665-5181",
            "fax_number": "843-665-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 2ND LOOP RD",
            "address_2": "SUITE C",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295052848",
            "telephone_number": "843-665-5181",
            "fax_number": "843-665-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "QMTD",
        "authorized_official_telephone_number": "252-702-9176",
        "authorized_official_credential": "MSW, LCSWA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina Em-I Medical Services PC
• South Carolina Interventional Pain - E, LLC
• Southern Home Care Services, Inc. (All Ways Caring HomeCare)
• Southern Medical
• Southern Support Services
• Southerncare, Inc. (SouthernCare Florence)
• Southland Health Care Center Inc
• Southland Operator LLC (Southland Health Care Center)
• Jefferson Krawulski Souza, CRNA
• Kristen Spang, MS, RDN, LD

• Community/Behavioral Health Agency in Florence, SC
• Providers in Florence, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.