Healthcare Provider Details
I. General information
NPI: 1063444800
Provider Name (Legal Business Name): SOUTHWEST GENERAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18659 DRAKE RD
STRONGSVILLE OH
44136-7059
US
IV. Provider business mailing address
18659 DRAKE RD
STRONGSVILLE OH
44136-7059
US
V. Phone/Fax
- Phone: 440-816-5000
- Fax: 440-816-5038
- Phone: 440-816-5040
- Fax: 440-816-5038
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 315D00000X |
| Taxonomy | Inpatient Hospice |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
YOUNG
JR.
Title or Position: PRESIDENT/CEO
Credential:
Phone: 440-816-6701