Provider Demographics
NPI:1003620451
Name:SWANSONS HOME CARE
Entity type:Organization
Organization Name:SWANSONS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BRABARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLACKMON
Authorized Official - Suffix:
Authorized Official - Credentials:AD
Authorized Official - Phone:574-710-3560
Mailing Address - Street 1:24423 STATE ROAD 23
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-9540
Mailing Address - Country:US
Mailing Address - Phone:574-710-3560
Mailing Address - Fax:
Practice Address - Street 1:24423 STATE ROAD 23
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-9540
Practice Address - Country:US
Practice Address - Phone:574-710-3560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health