SOUTHERN GRACE SERVICES (NPI# 1295193589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295193589 |
| Entity Type | Organization |
| Organization Name | SOUTHERN GRACE SERVICES |
| Other Organization Name | SOUTHERN GRACE - SENIOR HOME CARE |
| Practice Address |
1208a Carterville Rd Petal MS 39465-3115 |
| Practice Telephone | 6016025411 |
| Practice Fax Number | 6016025410 |
| Mailing Telephone | 6016025411 |
| Mailing Fax Number | 6016025410 |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |
| Authorized Official Name | DR. ALISA BERTEAU (OWNER) |
| Authorized Official Telephone | 9014913456 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385H00000X | Respite Care | Respite Care Facility |
| Other Name | Type Code |
|---|---|
| Southern Grace - Senior Home Care | Doing Business As Name - Organization |
| Street Address |
1208A CARTERVILLE RD |
| City | PETAL |
| State | MS |
| Zip Code | 39465-3115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055489 | R&p Elite Services, LLC | Private Vehicle | 68 Springfield Rd., Petal, MS 39465 | 2020-02-14 |
| 1003460544 | Hayden White | Pharmacist | 36 Byrd Dr., Petal, MS 39465 | 2019-08-01 |
| 1134612971 | Chandler Mccarley Hawkins | Dentist | 1115 Evelyn Gandy Parkway, Petal, MS 39465 | 2018-06-06 |
| 1881199818 | Lauren O'neal Garner | Nurse Practitioner | 36 Stadium Drive, Petal, MS 39465 | 2018-03-30 |
| 1700036928 | Petal School District | Registered Nurse | 60 Herrington Road, Petal, MS 39465 | 2008-09-24 |
| 1962679043 | Hattiesburg Eye Clinic Pa | Optometrist | 1223 Hwy 42, Ste 140, Petal, MS 39465 | 2008-05-08 |
| 1023228640 | Noal Baxter Cochran | Marriage & Family Therapist | 80 Lakeland Circle, Petal, MS 39465 | 2007-05-23 |
| 1750596938 | James A Nicholson Dds Pa | Dentist | 120 South 28th Avenue, Hattiesburg, MS 39465 | 2007-05-11 |
| 1356563605 | Petal School District | Registered Nurse | 400 Hillcrest Loop, Petal, MS 39465 | 2007-05-03 |
| 1154480804 | Mary E Thomsen | Orthotic Fitter | 173 Cherry Oak Trail, Petal, MS 39465 | 2006-12-08 |
| Find all providers in zip 39465 | ||||
| Taxonomy Code | 385H00000X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467050237 | Unified Home & Respite Care, LLC | Respite Care | 317 Highland Blvd Ste G, Natchez, MS 39120-4634 | 2020-10-14 |
| 1124636659 | Graceful Serenity LLC | Respite Care | 1440 Dunn Pease Rd, Raymond, MS 39154-8252 | 2020-07-21 |
| 1194342592 | Tashanda Chamberlin | Respite Care | 100 Hopper Ave, Dekalb, MS 39328 | 2020-07-01 |
| 1801412838 | Ycsc Gulf Coast Ms, LLC | Respite Care | 770 Water St Ste 428, Biloxi, MS 39530-4220 | 2020-06-25 |
| 1215552005 | Demetress Brent | Respite Care | 2941 Sheila Dr, Jackson, MS 39209-6125 | 2020-06-08 |
| 1912531427 | Magnolia Personal Care LLC | Respite Care | 69 Bo Stampley Rd, Fayette, MS 39069-4879 | 2020-02-24 |
| 1750935714 | La Respite, LLC | Respite Care | 701 Bowie Ln, Greenwood, MS 38930-5935 | 2019-07-29 |
| 1851944524 | Tracey Bernard Scurlock Jr. | Respite Care | 3747 Eureka Rd, Batesville, MS 38606-8064 | 2019-07-22 |
| 1295394377 | Divinity Community Living, Inc. | Respite Care | 405 Briarwood Dr Ste 108q, Jackson, MS 39206-3032 | 2019-06-11 |
| 1871062521 | Live, Laugh and Love Homecare Services | Respite Care | 604 Highway 80 W Ste Roffice1, Clinton, MS 39056-4108 | 2018-11-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.