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? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |