Provider Demographics
NPI:1144583121
Name:SOUTHWEST HOME HEALTH CARE SERVICES OF SAN ANTONIO, LLC
Entity Type:Organization
Organization Name:SOUTHWEST HOME HEALTH CARE SERVICES OF SAN ANTONIO, LLC
Other - Org Name:SOUTHWEST HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-560-8953
Mailing Address - Street 1:801 W ANN ARBOR TRL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1694
Mailing Address - Country:US
Mailing Address - Phone:734-455-1400
Mailing Address - Fax:775-258-1535
Practice Address - Street 1:7330 SAN PEDRO AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6235
Practice Address - Country:US
Practice Address - Phone:210-979-3800
Practice Address - Fax:210-979-3804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-24
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health