Southern Crescent Care,LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

075-R-0012 Issued in GA

Legal business name

SOUTHERN CRESCENT CARE,LLC

Practice address

135 Eagles Walk
Suite 325 a
Stockbridge, GA 30281-7206

Phone

(678) 565-8700

Fax

(678) 565-8775

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Mary Poore, LCSW, CNA

Title

Owner

Phone

(678) 565-8700

Specialties & licenses 1

Addresses

Other names 1

• Home Helpers Doing business as

Locations

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1851586028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 EAGLES WALK",
            "address_2": "SUITE 325 A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817206",
            "telephone_number": "678-565-8700",
            "fax_number": "678-565-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EAGLES WALK",
            "address_2": "SUITE 325 A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817206",
            "telephone_number": "678-565-8700",
            "fax_number": "678-565-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "POORE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-565-8700",
        "authorized_official_credential": "LCSW, CNA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "075-R-0012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Helpers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.