Provider Demographics
NPI:1508514084
Name:SWAN HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:SWAN HEALTH & WELLNESS LLC
Other - Org Name:AFFIRM AT HOME CARE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-214-2558
Mailing Address - Street 1:1174 IDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-5238
Mailing Address - Country:US
Mailing Address - Phone:254-214-2558
Mailing Address - Fax:
Practice Address - Street 1:1174 IDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76705-5238
Practice Address - Country:US
Practice Address - Phone:254-214-2558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SWAN HEALTH & WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care