National Provider Identifier Database

SOUTHERLAND CLARK ENTERPRISES LLC
Respite Care, Intellectual and/or Developmental Disabilities

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.


Contact Information

SOUTHERLAND CLARK ENTERPRISES LLC
315 N. LOUISVILLE ST.
HARLEM, GA30814
Phone: 706-955-5558
Fax:
Website:
Specialty Taxonomy Code
* Respite Care, Intellectual and/or Developmental Disabilities 385HR2060X

* Indicates primary specialty

NPI Profile & details for SOUTHERLAND CLARK ENTERPRISES LLC

NPI Number 1538539093
Legal business name
LBN
SOUTHERLAND CLARK ENTERPRISES LLC
Authorized official GLORIOUS JONES - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 09/28/2015
Last updated 10/27/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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