Southside Personal Care Home LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

SOUTHSIDE PERSONAL CARE HOME LLC

Practice address

5330 S 3Rd St Ste 200
Louisville, KY 40214-2689

Phone

(502) 533-1492

Fax

(502) 212-9292

NPI assigned

May 18, 2020

Last updated

Aug 7, 2020By 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

Mr. Abdirashid Ahmed Kanyare, ADMIN

Title

Manager

Phone

(502) 533-1492

Specialties & licenses 1

Addresses

Tax ID family

Southside Personal Care Home 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.

• Southside Personal Care Home LLC

  • Home Health Aide
  • Louisville, KY
  • NPI 1427671700
  NPD tax ID

Locations

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1740802354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 S 3RD ST STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402142689",
            "telephone_number": "502-533-1492",
            "fax_number": "502-212-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 S 3RD ST STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402142689",
            "telephone_number": "502-533-1492",
            "fax_number": "502-212-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PERSONAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "KANYARE",
        "authorized_official_first_name": "ABDIRASHID",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "502-533-1492",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMIN"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Home Care Services, Inc. (All Ways Caring HomeCare)
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Parkway Chiropractic PLLC
• Southside Personal Care Home LLC
• Southwest Center for the Developmentally Disabled (Southwest Center)
• Southwest Center for the Developmentally Disabled (Southwest Center)
• Southwest Center for the Developmentally Disabled (Southwest Center)
• Rebecca Ann Souza, PT
• Charles Robert Sowder, MD

• Home Health Aide in Louisville, KY
• Providers in Louisville, KY by specialty
• Home Health Aide in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.