Provider Demographics
NPI:1023476355
Name:SOUTHWEST HEALTH ALLEGIANCE LLC
Entity type:Organization
Organization Name:SOUTHWEST HEALTH ALLEGIANCE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:575-525-2273
Mailing Address - Street 1:3780 FOOTHILLS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8276
Mailing Address - Country:US
Mailing Address - Phone:575-525-2273
Mailing Address - Fax:575-527-1382
Practice Address - Street 1:3780 FOOTHILLS RD
Practice Address - Street 2:SUITE B
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8276
Practice Address - Country:US
Practice Address - Phone:575-525-2273
Practice Address - Fax:575-527-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based