Healthcare Provider Details

I. General information

NPI: 1417844044
Provider Name (Legal Business Name): SOUTHWEST GENERAL HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22021 BROOKPARK RD STE 122
FAIRVIEW PARK OH
44126-3100
US

IV. Provider business mailing address

1050 FORRER BLVD
KETTERING OH
45420-3640
US

V. Phone/Fax

Practice location:
  • Phone: 216-861-7422
  • Fax:
Mailing address:
  • Phone: 937-299-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EVERETT NEAL
Title or Position: PRESIDENT
Credential:
Phone: 937-299-1111