Provider Demographics
NPI:1326608274
Name:SOUTHWEST INDIANA HOME CARE LLC
Entity Type:Organization
Organization Name:SOUTHWEST INDIANA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-618-0916
Mailing Address - Street 1:PO BOX 5146
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5146
Mailing Address - Country:US
Mailing Address - Phone:812-618-0916
Mailing Address - Fax:
Practice Address - Street 1:2425 HIGHWAY 41 N STE 404
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-4070
Practice Address - Country:US
Practice Address - Phone:812-618-0916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care