Provider Demographics
NPI:1942055298
Name:SOUTHWEST ASSISTED LIVING-DEL RIO, LLC
Entity Type:Organization
Organization Name:SOUTHWEST ASSISTED LIVING-DEL RIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-215-5158
Mailing Address - Street 1:3850 HOLCOMB BRIDGE RD STE 350
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-5292
Mailing Address - Country:US
Mailing Address - Phone:770-870-0500
Mailing Address - Fax:
Practice Address - Street 1:1088 AMISTAD BLVD
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-2069
Practice Address - Country:US
Practice Address - Phone:770-870-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility