Provider Demographics
NPI:1447315718
Name:SOUTHSIDE CAREGIVERS,INC.
Entity type:Organization
Organization Name:SOUTHSIDE CAREGIVERS,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:RECREATIONAL THERAPI
Authorized Official - Phone:337-594-2090
Mailing Address - Street 1:1228 S WASHINGTON ST
Mailing Address - Street 2:SAME
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-4028
Mailing Address - Country:US
Mailing Address - Phone:877-594-2090
Mailing Address - Fax:
Practice Address - Street 1:1228 S WASHINGTON ST
Practice Address - Street 2:SAME
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-4028
Practice Address - Country:US
Practice Address - Phone:337-594-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care