Southern Hospitality Home Support Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HC1088 Issued in NC

Legal business name

SOUTHERN HOSPITALITY HOME SUPPORT CARE

Practice address

2310 Southern Ave
Fayetteville, NC 28306-2260

Phone

(910) 485-8003

Fax

(910) 485-8140

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Rosalie P. Crowe, RN

Title

Director

Phone

(910) 485-8003

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720153950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64526",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283060526",
            "telephone_number": "910-485-8003",
            "fax_number": "910-485-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 SOUTHERN AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062260",
            "telephone_number": "910-485-8003",
            "fax_number": "910-485-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HOSPITALITY HOME SUPPORT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROWE",
        "authorized_official_first_name": "ROSALIE",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-485-8003",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600239",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408513",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeastern Motor and Sensory Specialists
• Southeastern Radiation Oncology
• Southern Ave Rest Home
• Southern Family Markets LLC
• Southern Healthcare Network
• Southern Internal Medicine, PC
• Amy E. Southworth
• Karen Michelle Soutullo
• Sammy M Soza III
• Jennifer Mode Spackman, PSY.D.

• Home Health Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.