SOUTHERN COMMUNITY SERVICES INC – NPI #1417112707
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

SOUTHERN COMMUNITY SERVICES INC is a community based residential treatment facility located in DOUGLAS, GA. NPPES has assigned the NPI number 1417112707 to SOUTHERN COMMUNITY SERVICES INC on July 25, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHERN COMMUNITY SERVICES INC below.

NPI Profile for
SOUTHERN COMMUNITY SERVICES INC

NPI Number
1417112707
Enumeration Date

(about 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHERN COMMUNITY SERVICES INC
Primary location
315 S. GASKIN AVE
DOUGLAS, GA 31533
Phone: (912) 393-3466 Fax: (912) 393-1103
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LISA MOORE
MANAGER
Phone: (912) 393-3466
Updated
Identifiers

Identifiers for SOUTHERN COMMUNITY SERVICES INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDGA290464766A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
GA 034-01-019-8

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.