Provider Demographics
NPI:1780025007
Name:SOUTHWEST HOME CARE, LLC
Entity type:Organization
Organization Name:SOUTHWEST HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAKEITHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-539-5290
Mailing Address - Street 1:920 E SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS
Mailing Address - State:NM
Mailing Address - Zip Code:87020-2436
Mailing Address - Country:US
Mailing Address - Phone:505-287-7472
Mailing Address - Fax:505-287-7473
Practice Address - Street 1:920 E SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2436
Practice Address - Country:US
Practice Address - Phone:505-287-7472
Practice Address - Fax:505-287-7473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03-191409-00-8251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health