Southerncare Green Bay

LBN: Southerncare, Inc.
Southerncare Green Bay is an health care organization with primary practice located at 1800 W Mason St Ste A , Green Bay WI 54303-2333. The organization recently has only one registered license in Agencies / Hospice Care, Community Based, which is considered as the primary health care specialty. Southerncare, Inc. can be contacted via phone (920) 496-1690, or through Kleberg, Jessica via phone (704) 664-2876.

Contact Information

Primary practice address
1800 W Mason St Ste A Green Bay WI 54303-2333
Phone: (920) 496-1690
Fax: (920) 496-1693
Website:
Map and Directions
Authorized official contact:
Name: Kleberg, Jessica
Phone: (704) 664-2876

Health care specialties

SpecialtyCodeLicense #State
Agencies / Hospice Care, Community Based 251G00000X
Agencies / Hospice Care, Community Based 251G00000X 2016 Wisconsin

Profile Details

NPI number 1992744775
LBN Legal business name Southerncare, Inc.
DBA Doing business as Southerncare Green Bay
Authorized official Kleberg, Jessica
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2006
Last updated Nov 13th, 2017 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992744775 NPPES
Wisconsin Other 2016 STATE LICENSE NUMBER
Wisconsin MEDICAID 43191100 STATE LICENSE NUMBER

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