Healthcare Provider Details

I. General information

NPI: 1962315457
Provider Name (Legal Business Name): SW RESIDENTIAL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 CHANDLER AVE
FORT MYERS FL
33907-4247
US

IV. Provider business mailing address

2355 CHANDLER AVE
FORT MYERS FL
33907-4247
US

V. Phone/Fax

Practice location:
  • Phone: 239-544-7222
  • Fax:
Mailing address:
  • Phone: 239-544-7222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ROSE MICHELLE CAZEAU CHERUBIN
Title or Position: MANAGER
Credential:
Phone: 239-544-7222