| NPI | 1518904853 |
|---|---|
| Doing Business As | SOUTHERNCARE VIDALIA |
| Entity Type | Organization |
| Authorized Contact | JESSICA KLEBERG VP Of Legal Affairs 704-664-2876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251G00000X Hospice Care, Community Based (Licence: GA 138-149-H) |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based (Licence: GA 138186H) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2016-05-16 |