Provider Demographics
NPI:1518357037
Name:SOUTHWEST HEALTHCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:SOUTHWEST HEALTHCARE SOLUTIONS, LLC
Other - Org Name:HOME CARE IN LAS VEGAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-200-1519
Mailing Address - Street 1:245 E CENTENNIAL PKWY
Mailing Address - Street 2:# 2039
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1354
Mailing Address - Country:US
Mailing Address - Phone:619-200-1519
Mailing Address - Fax:702-476-5125
Practice Address - Street 1:245 E CENTENNIAL PKWY
Practice Address - Street 2:# 2039
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1354
Practice Address - Country:US
Practice Address - Phone:619-200-1519
Practice Address - Fax:702-476-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20121553209251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1063763555Medicaid