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NPI Code Detail

MEDICARE: SOUTHWEST HEALTHCARE CENTER LLC

MEDICARE: SOUTHWEST HEALTHCARE CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1396415584
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST HEALTHCARE CENTER LLC
Provider Business Mailing Address
First Line : 3131 W CRAIG RD STE 180
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0861
Country : US
Telephone Number : 702-469-7897
Fax Number :
Provider Business Practice Location Address
First Line : 3277 W CRAIG RD STE 100-130
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0792
Country : US
Telephone Number : 702-272-4393
Fax Number :
Authorized Official
Title or Position : CEO
Name : BARBARA DEDEAUX
Credential :
Telephone Number : 702-272-4393
Provider Enumeration Date : 09/17/2021
Last Update Date : 09/17/2021

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Directions to “SOUTHWEST HEALTHCARE CENTER LLC ” Practice Location

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