Southern Living LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SOUTHERN LIVING LLC

Practice address

4466 47TH St S Apt 309
Fargo, ND 58104-4368

Phone

(706) 254-6417

NPI assigned

Dec 18, 2024

Organization subpart

No

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

Authorized official

Name

Angela Addae-AboagyeNPI 1861230351

Title

Ceo

Phone

(706) 254-6417

Specialties & licenses 1

Addresses

Other names 1

• Southern Living LLC Doing business as

Tax ID family

Southern Living LLC2 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 Living LLC

  • Personal Care Attendant
  • Fargo, ND
  • NPI 1457189433
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela Addae-Aboagye

  • Nurse's Aide
  • Fargo, ND
  • NPI 1861230351
  NPD Authorized official

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1497563860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9472",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581069472",
            "telephone_number": "706-254-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 47TH ST S APT 309",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044368",
            "telephone_number": "706-254-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "ADDAE-ABOAGYE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-254-6417"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Living LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeast Care LLC
• Southeast Human Service Center
• Southeast Human Service Center
• Southeastern North Dakota Community Action Agency
• Southern Living LLC
• Claudette Souverain
• Alexander Paul Spacek, MD
• Caroline Ann Spacek, CFO
• Samantha Jo Spaeth, PT, DPT
• Elska Marie Spanier

• In Home Supportive Care Agency in Fargo, ND
• Providers in Fargo, ND by specialty
• In Home Supportive Care Agency in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.