Southern Comfort Pca, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SOUTHERN COMFORT PCA, LLC

Practice address

4428 E Azure Ave
Las Vegas, NV 89115-6028

Phone

(702) 417-4702

NPI assigned

Apr 11, 2019

Organization subpart

No

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

Authorized official

Name

Quanika Simpson-Jackson

Title

Owner

Phone

(702) 417-4702

Specialties & licenses 1

Addresses

Other names 1

• Beautiful Reflections Home Care. LLC Doing business as

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1407319833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 E AZURE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156028",
            "telephone_number": "702-417-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4428 E AZURE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156028",
            "telephone_number": "702-417-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COMFORT PCA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "SIMPSON-JACKSON",
        "authorized_official_first_name": "QUANIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-417-4702"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beautiful Reflections Home Care. LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Las Vegas Medical Investors Limited Partnership
• South Las Vegas Medical Investors, LLC
• Melissa Renee South, RN
• Melissa Southard
• Souther Nevada Adult Mental Health
• Southern Girl LLC
• Southern Highlands Dental, LLC
• Southern Hills Comprehensive Treatment Center
• Southern Hills Dialysis Center LLC
• Southern Hills Hospital and Medical Center

• Home Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Home Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.