Provider Demographics
NPI:1740219450
Name:SOUTHWEST HOME HEALTH CARE, LP
Entity Type:Organization
Organization Name:SOUTHWEST HOME HEALTH CARE, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT MPT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LAMON
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:210-979-3800
Mailing Address - Street 1:801 W ANN ARBOR TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1694
Mailing Address - Country:US
Mailing Address - Phone:734-414-9990
Mailing Address - Fax:775-258-1535
Practice Address - Street 1:7330 SAN PEDRO AVENUE
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216
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:2006-07-03
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009659251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179063601Medicaid
TX457876Medicare Oscar/Certification